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Association of Oxidized Low-Density Lipoprotein With Prognosis of Stroke and Stroke Subtypes
Anxin Wang1, Yuling Yang1, Zhaoping Su1
1From the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (A.W., Yongjun Wang, Yilong Wang); China National Clinical Research Center for Neurological Diseases, Beijing, China (A.W., Yongjun Wang, Yilong Wang); Center of Stroke, Beijing Institute for Brain Disorders, China (A.W., Yongjun Wang, Yilong Wang); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (A.W., Yongjun Wang, Yilong Wang); Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China (A.W.); Departments of Neurology, Tangshan Gongren Hospital, China (Yuling Yang, Y.C.); Department of Epidemiology and Health Statistics, Academy of Public Health and Management, Weifang Medical University, China (Z.S.); Department of Neurology, Second Hospital of Tianjin Medical University, China (W.Y.); Department of Neurology, Tianjin Huanhu Hospital, China (W.Y.); Department of Neurology, Peking University First Hospital, Beijing, China (H.H.); and Department of Neurology, Shenzhen Second People's Hospital, China (L.R.).
Background And Purpose:
The association between oxidized low-density lipoprotein (oxLDL) and the long-term prognosis of stroke is unclear. The aim of this study is to investigate whether oxLDL levels contribute to the prognosis of stroke and stroke subtypes.
Methods:
All patients with ischemic stroke were recruited from the SOS-Stroke (Study of Oxidative Stress in Patients With Acute Ischemic Stroke) and classified into 5 different subtypes, according to the TOAST criteria (Trial of Org 10172 in Acute Stroke Treatment). We measured oxLDL levels and followed up with patients at 1 year after stroke onset. We analyzed the association between oxLDL and the clinical outcomes of death and poor functional outcome (modified Rankin Scale score of 3-6) of stroke and different stroke subtypes.
Results:
Among the 3688 patients included in this study, 293 (7.94%) were deceased at the 1-year follow-up and 1020 (27.66%) had a poor functional outcome. Patients in the highest oxLDL quartile had a higher risk of 1-year stroke mortality (hazard ratio, 1.61; 95% confidence interval, 1.10-2.33; P<0.001) and a poor functional outcome (odds ratio, 1.48; 95% confidence interval, 1.15-1.89; P<0.001) compared with the lowest oxLDL quartile. In the subgroup analyses, oxLDL was only significantly associated with death and poor functional outcome in the large-artery atherosclerosis subgroup (P<0.05) and small-artery occlusion subgroup (P<0.05).
Conclusions:
High levels of oxLDL were associated with the high risk of death and poor functional outcome within 1 year after stroke onset, especially in large-artery atherosclerosis and small-artery occlusion stroke subtypes.
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