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Published on: February 26, 2013
LDL-C/HDL-C is associated with ischaemic stroke in patients with non-valvular atrial fibrillation: a case-control
Xiao-Xue Zhang1,2, Meng Wei1,2, Lu-Xiang Shang1,2
1Department of Cardiac Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, No. 137, Liyushan Road, Urumqi, 830054, P R China.
Insights
The low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) is a key predictor of ischaemic stroke (IS) in non-valvular atrial fibrillation (NVAF) patients. Elevated LDL-C/HDL-C, obesity, and smoking significantly increase IS risk.
Area of Science:
- Cardiology
- Neurology
- Clinical Research
Background:
- Non-valvular atrial fibrillation (NVAF) poses a significant risk for ischaemic stroke (IS).
- Understanding clinical indicators associated with IS in NVAF patients is crucial for risk stratification and management.
- The role of the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) in IS among NVAF patients in Xinjiang requires further investigation.
Purpose of the Study:
- To explore the relationship between the LDL-C/HDL-C ratio and other clinical indicators with IS in Xinjiang NVAF patients.
- To identify independent risk factors for IS in this patient population.
- To provide a theoretical and therapeutic basis for managing NVAF patients at risk of IS.
Main Methods:
- A case-control study involving 798 IS patients and 2671 controls with NVAF from 10 medical centers in Xinjiang.
- Univariate and multivariate logistic regression analyses were employed to identify independent risk factors.
- Factor analysis, principal component regression, and ROC curve analysis were used to assess the influence and predictive ability of LDL-C/HDL-C.
Main Results:
- The highest LDL-C/HDL-C quartile (≥2.73) was associated with a 16.23-fold increased risk of IS compared to the lowest quartile (<1.22).
- Obesity (2.27-fold) and smoking (3.15-fold) were also significant independent risk factors for IS.
- The LDL-C/HDL-C ratio demonstrated good discriminatory ability for predicting IS, with an AUC of 0.76.
Conclusions:
- Elevated LDL-C/HDL-C (>1.22), smoking, BMI ≥24 kg/m², and CHA₂DS₂-VASc score are independent risk factors for IS in NVAF patients.
- The LDL-C/HDL-C ratio emerged as the primary risk factor influencing IS occurrence.
- These findings underscore the importance of lipid management and lifestyle modifications in preventing IS in NVAF patients.
Background:
This study explored the relationships between the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and other clinical indicators and ischaemic stroke (IS) in patients with non-valvular atrial fibrillation (NVAF) in Xinjiang. The findings could provide a theoretical and therapeutic basis for NVAF patients.
Methods:
NVAF patients who were admitted to 10 medical centres across Xinjiang were divided into stroke (798 patients) and control (2671 patients) groups according to the occurrence of first acute IS. Univariate and multivariate logistic regression analysis were used to examine the independent risk factors for IS in NVAF patients. Factor analysis and principal component regression analysis were used to analyse the main factors influencing IS. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminatory ability of LDL-C/HDL-C for predicting the occurrence of IS.
Results:
The stroke group had an average age of 71.64 ± 9.96 years and included 305 females (38.22%). The control group had a mean age of 67.30 ± 12.01 years and included 825 females (30.89%). Multivariate logistic regression showed that the risk of IS in the highest LDL-C/HDL-C quartile (≥2.73) was 16.23-fold that of the lowest quartile (< 1.22); IS risk was 2.27-fold higher in obese patients than in normal-weight subjects; IS risk was 3.15-fold higher in smoking patients than in non-smoking patients. The area under the ROC curve of LDL-C/HDL-C was 0.76, the optimal critical value was 2.33, the sensitivity was 63.53%, and the specificity was 76.34%. Principal component regression analysis showed that LDL-C/HDL-C, age, smoking, drinking, LDL-C and hypertension were risk factors for IS in NVAF patients.
Conclusions:
LDL-C/HDL-C > 1.22, smoking, BMI ≥24 kg/m2 and CHA2DS2-VASc score were independent risk factors for IS in NVAF patients; LDL-C/HDL-C was the main risk factor.
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