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Plasma l-carnitine and risks of cardiovascular events and recurrent stroke after ischemic stroke: A nested
Jigang Du1, Mengyuan Miao1, Zian Lu1
1Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
Insights
Higher plasma l-carnitine levels are linked to reduced cardiovascular events and stroke recurrence in ischemic stroke patients. This suggests l-carnitine may serve as a valuable prognostic marker for risk stratification.
Area of Science:
- Cardiovascular Research
- Neurology
- Metabolic Medicine
Background:
- l-Carnitine is known for cardioprotective effects and preventing atherosclerosis.
- Limited epidemiological data exists on plasma l-carnitine and cardiovascular risks post-stroke.
- Investigating l-carnitine's role in ischemic stroke outcomes is crucial.
Purpose of the Study:
- To explore the association between plasma l-carnitine levels and cardiovascular events.
- To investigate the relationship between plasma l-carnitine and stroke recurrence after ischemic stroke.
- To determine if l-carnitine can serve as a prognostic marker in stroke patients.
Main Methods:
- A nested case-control study design was employed.
- 323 cardiovascular events (264 recurrent strokes) and matched controls were analyzed.
- Plasma l-carnitine was quantified using ultra-high-performance LC-MS/MS.
- Conditional logistic regression models were used to assess outcome risks.
Main Results:
- Plasma l-carnitine showed an inverse association with cardiovascular events (OR=0.69) and recurrent stroke (OR=0.72) per SD increase.
- Participants in the highest l-carnitine tertiles had significantly lower risks of events and recurrence.
- l-Carnitine demonstrated incremental predictive value beyond established risk factors.
Conclusions:
- Elevated plasma l-carnitine levels correlate with reduced risks of cardiovascular events and recurrent stroke.
- Plasma l-carnitine shows potential as a prognostic marker for risk stratification in ischemic stroke patients.
- Further research can validate l-carnitine's therapeutic and diagnostic potential in stroke management.
Background And Aims:
l-Carnitine was suggested to prevent the progression of atherosclerosis, myocardial and neurologic injury, and exhibited cardioprotective effects. However, epidemiological data on circulating l-carnitine and risks of cardiovascular events in the setting of stroke is rare. We aimed to explore the relationships between plasma l-carnitine and cardiovascular events and stroke recurrence after ischemic stroke in a nested case-control study.
Methods And Results:
A total of 323 cardiovascular events (including 264 recurrent strokes) and 323 matched controls (free of recurrent cardiovascular events) were included. Study outcomes included cardiovascular events and recurrent stroke after ischemic stroke. Plasma l-carnitine concentrations were measured by ultra-high-performance LC-MS/MS. Conditional logistic regression models were used to estimate odds ratios (ORs) of stroke outcomes. Plasma l-carnitine was inversely associated with cardiovascular events (OR = 0.69, 95% CI: 0.57-0.84 per SD) and recurrent stroke (OR = 0.72, 95% CI: 0.58-0.88 per SD) after adjusting for established risk confounders. Compared with the lowest tertile of l-carnitine, adjusted ORs of cardiovascular events and recurrent stroke for participants in the highest tertiles were 0.35 (95% CI: 0.21-0.57) and 0.36 (95% CI: 0.21-0.62), respectively. In addition, l-carnitine provided incremental predictive ability beyond established risk factors, shown by increase in C statistics, net reclassification improvement and integrated discrimination improvement.
Conclusions:
Higher l-carnitine levels were associated with lower risks of cardiovascular events and recurrent stroke after ischemic stroke. Our findings provided evidence supporting plasma l-carnitine as a potential prognostic marker in risk discrimination and stratification in patients with ischemic stroke.
Trial Registration:
Clinicaltrials.gov as NCT01840072. URL: https://www.
Clinicaltrials:
gov.
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