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Published on: November 10, 2017
Elevated remnant cholesterol is a risk factor for acute ischemic stroke
Qian Feng1, Hao Li2, Ru-Yang Zhang3
1Department of Neurology, the First Affiliated Hospital of Soochow University, China; Department of Neurology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.
Insights
Remnant cholesterol (RC) is an independent risk factor for acute ischemic stroke (AIS). The risk is non-linear, particularly in diabetic patients, highlighting RC
Area of Science:
- Cardiovascular Medicine
- Neurology
- Clinical Chemistry
Background:
- Remnant cholesterol (RC) is implicated in atherosclerosis pathogenesis.
- The specific association between RC and acute ischemic stroke (AIS) remains incompletely understood.
- Identifying independent risk factors for AIS is crucial for prevention strategies.
Purpose of the Study:
- To investigate whether fasting blood remnant cholesterol (RC) levels represent an independent risk factor for acute ischemic stroke (AIS).
- To elucidate the nature of the relationship between RC and AIS risk.
Main Methods:
- Retrospective analysis of 650 AIS patients and 598 healthy controls.
- Binary logistic regression to assess the association between RC and AIS.
- Restricted Cubic Splines (RCS) analysis to model the non-linear relationship between RC and AIS risk.
Main Results:
- Remnant cholesterol (RC) levels were significantly higher in AIS patients compared to controls.
- RC was confirmed as an independent risk factor for AIS, even after adjusting for covariates.
- A non-linear association was observed: AIS risk increased with RC up to 0.69 mol/L, then plateaued.
- In diabetic patients, AIS risk increased significantly with RC, especially above 1.15 mol/L.
Conclusions:
- Remnant cholesterol (RC) is a validated independent risk factor for acute ischemic stroke (AIS).
- The study reveals a distinct non-linear association between RC levels and AIS risk.
- Findings emphasize the importance of RC in AIS risk stratification, particularly for diabetic individuals.
Objectives:
Remnant cholesterol (RC) is thought to be an important pathogenic risk factor for atherosclerosis, however, the relationship between RC and acute ischemic stroke (AIS) is still unclear. This study aimed to determine whether fasting blood RC level is an independent risk factor for AIS.
Materials And Methods:
A retrospective analysis was performed on 650 patients with AIS and 598 healthy controls during the same time period. The association between RC and AIS was investigated using binary logistic regression, and the relationship between RC and AIS risk was demonstrated using Restricted Cubic Splines (RCS).
Results:
RC was significantly higher in the AIS group compared with control group, and was an independent risk factor for AIS when the covariates were not adjusted;After adjusting some covariates, RC was still an independent risk factor for AIS. The RCS analysis found the risk was non-linear: when RC concentration was less than 0.69 mol/L, the risk of AIS increased with the elevation of RC, and when RC concentration was more than or equal to 0.69 mol/L, the risk of AIS was insignificant with the elevation of RC. Correlation analysis revealed that RC was associated with diabetes and fasting glucose. Further analysis revealed that the incidence of AIS in diabetic patients increased significantly with the increase of RC, and RCS analysis revealed that the risk of AIS in diabetic patients increased with the increase of RC when RC was more than 1.15 mol/L.
Conclusions:
This study confirms RC as an independent risk factor for AIS, which highlights a distinct non-linear association between RC levels and AIS risk. These findings suggest the need for targeted AIS risk assessment strategies, especially in diabetic patients, and underscore the relevance of RC as a biomarker in AIS risk stratification.
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