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Nontraditional serum lipid variables and recurrent stroke risk.

Jong-Ho Park¹, Juneyoung Lee¹, Bruce Ovbiagele¹

¹From the Department of Stroke Neurology, Myongji Hospital, Goyang, Korea (J.-H.P.); Department of Biostatistics, College of Medicine, Korea University, Seoul, Korea (J.L.); and Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina (J.-H.P., B.O.).

|September 20, 2014

Summary

The triglycerides/high-density lipoprotein cholesterol (HDL-C) ratio, not LDL-C, predicts recurrent stroke and vascular events. This lipid ratio may be a therapeutic target for stroke survivors.

Keywords:

cardiovascular diseases lipids stroke

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Area of Science:

Cardiovascular Medicine
Neurology
Lipidology

Background:

Current stroke guidelines prioritize low-density lipoprotein cholesterol (LDL-C) for secondary prevention.
Emerging evidence suggests other lipid parameters may also predict cardiovascular risk.
The impact of nontraditional lipid variables on recurrent stroke risk remains under-investigated.

Purpose of the Study:

To investigate the association of nontraditional lipid variables with recurrent ischemic stroke risk.
To evaluate the predictive value of various lipid ratios and components for vascular events post-stroke.

Main Methods:

Analysis of the Vitamin Intervention for Stroke Prevention study database (n=3680).
Inclusion of recent noncardioembolic stroke patients with 2-year follow-up.
Assessment of independent associations between baseline lipid variables and outcomes.

Main Results:

Elevated triglycerides/high-density lipoprotein cholesterol (HDL-C) ratio independently predicted recurrent ischemic stroke and composite vascular events.
The highest quintile of triglycerides/HDL-C ratio showed increased risk for stroke (aHR, 1.56) and composite events (aHR, 1.39).
Elevated total cholesterol/HDL-C ratio predicted composite vascular events, but not recurrent stroke independently.

Conclusions:

The triglycerides/HDL-C ratio is a significant predictor of vascular risk after stroke.
This lipid ratio, unlike LDL-C, may serve as a potential therapeutic target for reducing global vascular risk in stroke patients.
Further research is warranted to confirm the therapeutic role of targeting the triglycerides/HDL-C ratio.