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Non-High-Density Lipoprotein Cholesterol Predicts Adverse Outcomes in Acute Ischemic Stroke
Guangyao Wang1,2,3,4, Jing Jing1,2,3,4, Anxin Wang1,2,3,4
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (G.W., J.J., A.W., X. Zhang, X. Zhao, Z.L., C.W., H.L., L.L., Yongjun Wang, Yilong Wang).
Insights
High non-HDL cholesterol levels predict increased risk of recurrent ischemic stroke and death within one year in stroke patients. Lower levels also increased death risk, while intracranial hemorrhage risk was unaffected.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Clinical Lipidology
Background:
- Non-high-density lipoprotein cholesterol (non–HDL-C) is linked to adverse cardiovascular events.
- Understanding non–HDL-C's role in acute ischemic stroke is crucial for patient outcomes.
Purpose of the Study:
- To investigate the association between non–HDL-C levels and adverse outcomes in patients with acute ischemic stroke.
- To determine if non–HDL-C predicts recurrent stroke, intracranial hemorrhage, or all-cause death.
Main Methods:
- Analysis of 16,113 patients from the China National Stroke Registry II with acute ischemic stroke.
- Patients categorized into quintiles based on non–HDL-C levels.
- Cox regression models used to assess the relationship between non–HDL-C and outcomes within 1 year.
Main Results:
- Elevated non–HDL-C (top quintile) was associated with a 46% increased risk of recurrent ischemic stroke.
- Both lowest and highest non–HDL-C levels were linked to a higher risk of all-cause death.
- Non–HDL-C levels did not significantly predict intracranial hemorrhage risk.
Conclusions:
- Non–HDL-C demonstrates potential as a predictor for recurrent ischemic stroke and all-cause mortality in acute ischemic stroke patients.
- These findings highlight the importance of monitoring non–HDL-C for risk stratification in stroke survivors.
Background And Purpose:
Non–high-density lipoprotein cholesterol (non–HDL-C) was significantly related to adverse outcomes in patients with cardiovascular disease. We aim to investigate the associations of non-HDL-C and adverse outcomes in acute ischemic stroke.
Methods:
Among 19 604 patients with acute ischemic stroke admitted to the China National Stroke Registry II, 16 113 with both total cholesterol and HDL-C were analyzed. Patients were classified into 5 groups by quintiles of non-HDL-C. The outcomes included recurrent ischemic stroke, intracranial hemorrhage, and all-cause death within 1 year. The relationship of non-HDL-C with the risk of outcomes was analyzed by Cox regression models.
Results:
Among the 16 113 patients, the median (interquartile range) of non-HDL-C was 3.41 (2.78–4.10) mmol/L. After adjustment for confounding variables, patients in the top quintile of non-HDL-C were associated with higher risk of recurrent ischemic stroke within 1 year (adjusted hazard ratio, 1.46 [95% CI, 1.20–1.77]), compared with those in the third quintile. Patients in the bottom and top quintile of non-HDL-C were associated with higher risk of all-cause death within 1 year (adjusted hazard ratio, 1.22 [95% CI, 1.01–1.47] and adjusted hazard ratio, 1.40 [95% CI, 1.15–1.70], respectively), compared with those in the third quintile. However, non-HDL-C levels were not significantly predictive in intracranial hemorrhage.
Conclusions:
Non-HDL-C may be a qualified predictor for recurrent ischemic stroke and all-cause death within 1 year in patients with acute ischemic stroke.
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