Traditional Lipid Ratios and Carotid Atherosclerosis in Patients with Ischemic Stroke
Mengyuan Miao1, Chunyue Ye1, Ziyi Wang1
1Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China.
Insights
Elevated traditional lipid ratios, including Castelli's risk indices and atherogenic coefficient, are linked to carotid atherosclerosis in ischemic stroke patients. These ratios show promise as predictors of atherosclerosis, aiding in risk assessment.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Clinical Chemistry
Background:
- Traditional lipid ratios are established cardiovascular disease risk predictors.
- The association between lipid ratios and atherosclerosis in ischemic stroke patients is not well-defined.
Purpose of the Study:
- To investigate the relationship between traditional lipid ratios and carotid atherosclerosis in patients who have experienced an ischemic stroke.
Main Methods:
- Analysis of 1,612 ischemic stroke patients from 22 hospitals.
- Assessment of Castelli's risk index-I (CRI-I), Castelli's risk index-II (CRI-II), and atherogenic coefficient (AC).
- Logistic regression models and restricted cubic spline models were employed.
Main Results:
- Higher levels of CRI-I, CRI-II, and AC were significantly associated with increased odds of carotid atherosclerosis.
- Dose-response relationships were observed between these lipid ratios and carotid atherosclerosis, as well as abnormal mean and maximum carotid intima-media thickness (cIMT).
- Lipid ratios demonstrated incremental predictive value for carotid atherosclerosis beyond existing risk factors.
Conclusions:
- Elevated traditional lipid ratios are positively associated with carotid atherosclerosis in ischemic stroke patients.
- These lipid ratios may serve as valuable predictors for atherosclerosis in this patient population.
Introduction:
Traditional lipid ratios were considered as robust predictors of cardiovascular disease risk. However, the relationships between traditional lipid ratios and atherosclerosis in the setting of ischemic stroke remain unclear. We aimed to explore the associations between traditional lipid ratios and carotid atherosclerosis in patients with ischemic stroke.
Methods:
A total of 1,612 patients with ischemic stroke from 22 hospitals were included in this analysis. Traditional lipid ratios included Castelli's risk index-I (CRI-I), Castelli's risk index-II (CRI-II), and atherogenic coefficient (AC). Logistic regression models were used to assess the relationships between traditional lipid ratios and carotid atherosclerosis.
Results:
The multivariable-adjusted odds ratios (ORs) (95% confidence intervals [CIs]) in quartile 4 versus quartile 1 of CRI-I, CRI-II, and AC were 1.65 (1.14-2.38), 1.48 (1.03-2.14), and 1.65 (1.14-2.38) for carotid atherosclerosis. Furthermore, the ORs (95% CIs) for the highest quartile of CRI-I, CRI-II, and AC were 1.51 (1.09-2.09), 1.38 (0.99-1.90), and 1.51 (1.09-2.09) for abnormal mean cIMT and were 1.60 (1.17-2.18), 1.59 (1.17-2.16), and 1.60 (1.17-2.18) for abnormal maximum cIMT, respectively. Restricted cubic spline models indicated that there were dose-response relationships between CRI-I, CRI-II, and AC and carotid atherosclerosis and abnormal cIMT (all P for linearity <0.001). Additionally, CRI-I, CRI-II, and AC offered incremental predictive capacity for carotid atherosclerosis beyond established risk factors, shown by increase in net reclassification improvement and integrated discrimination improvement (all p < 0.05).
Conclusion:
Elevated traditional lipid ratios were positively associated with carotid atherosclerosis in patients with ischemic stroke, supporting that these lipid ratios could be promising atherosclerotic predictors.
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