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Predictive value of ApoB/ApoA-I for recurrence within 1 year after first incident stroke
Jie Lin1, Zhihua Si2, Aihua Wang2
1Department of Neurology, Shandong Provincial Qianfoshan Hospital, Shandong University, Shandong Institute of Neuroimmunology, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong, China.
Insights
The ApoB/ApoA-I ratio, a key cholesterol balance indicator, predicts ischemic stroke recurrence. Higher ratios in acute stroke patients significantly correlate with increased stroke recurrence risk within one year.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Biochemistry
Background:
- The apolipoprotein B (ApoB)/apolipoprotein A-I (ApoA-I) ratio is a recognized marker for assessing cholesterol balance.
- This ratio is particularly valuable in predicting the risk of ischemic events.
Purpose of the Study:
- To evaluate the prognostic capability of the ApoB/ApoA-I ratio.
- To determine its association with stroke recurrence within one year following an initial ischemic stroke event.
Main Methods:
- A retrospective analysis of 722 patients diagnosed with acute ischemic stroke.
- Measurement of serum ApoB and ApoA-I levels upon admission.
- Statistical analysis, including Kaplan-Meier curves and Cox regression, to assess the relationship between the ApoB/ApoA-I ratio and 1-year stroke recurrence.
Main Results:
- A 14.1% rate of stroke recurrence within one year was observed.
- Patients experiencing recurrence had significantly higher admission ApoB/ApoA-I ratios (P < 0.001).
- The ApoB/ApoA-I ratio showed a significant positive correlation with 1-year stroke recurrence risk (HR 4.007), even after adjusting for traditional risk factors.
Conclusions:
- The ApoB/ApoA-I ratio measured during the acute phase of a first stroke is a significant predictor of recurrent stroke within one year.
- This association remained robust across different patient subgroups, including those with varying LDL-C levels and specific stroke types like Large Artery Atherosclerosis (LAA).
Background:
ApoB/ApoA-I ratio is a reliable indicator of cholesterol balance, particularly in the prediction of ischemic events risk. The aim of this study was to investigate the prognostic value of ApoB/ApoA-I for stroke recurrence within 1 year after the first incident.
Methods:
We retrospectively included patients who were first diagnosed with acute (<7 days after onset) ischemic stroke. Blood samples were collected on admission, and serum ApoB and ApoA-I concentrations were measured. We analyzed the relationship between ApoB/ApoA-I ratio and ischemic stroke recurrence within 1 year.
Results:
A total of 722 patients with acute ischemic stroke were included, of whom 102 experienced stroke recurrence within 1 year, with a recurrence rate of 14.1%. Serum ApoB/ApoA-I concentrations on admission were higher in patients with stroke recurrence at 1 year compared with those with a good prognosis (P < 0.001). The Kaplan-Meier survival curve revealed a significant difference in cumulative stroke recurrence rates across ApoB/ApoA-I tertiles (log-rank P-value < 0.001). A positive correlation between the ApoB/ApoA-I ratio and the risk of stroke recurrence within 1 year was demonstrated using Cox regression analysis, which remained significant after adjusting for traditional risk factors [hazard ratio (HR) 4.007, 95% confidence interval (CI) 1.661-9.666]. This relationship was particularly strong in patients with LAA stroke (HR 4.955, 95% CI 1.591-15.434). Subgroup analysis further revealed that a high ApoB/ApoA-I ratio was strongly associated with stroke recurrence regardless of whether patients had high or low LDL-C levels.
Discussion:
ApoB/ApoA-I ratio, measured during the acute phase of the first stroke, was positively correlated with the risk of stroke recurrence within 1 year.
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