THR as a Novel Biomarker for Carotid Stenosis Severity in Acute Ischemic Stroke: Implications for Risk Stratification
Cong Wu1, Yi Lv2, Conghuan Wang3
1The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Insights
The total cholesterol to high-density lipoprotein cholesterol ratio (THR) effectively predicts carotid stenosis severity in acute ischemic stroke (AIS) patients. This cost-effective biomarker aids in risk stratification and personalized treatment strategies.
Area of Science:
- Cardiology
- Neurology
- Biomarkers
Background:
- Acute ischemic stroke (AIS) patients often have concomitant carotid stenosis.
- Assessing carotid stenosis severity is crucial for stroke risk stratification and management.
- Novel biomarkers for predicting stenosis severity in AIS are needed.
Purpose of the Study:
- To investigate the predictive role of the total cholesterol to high-density lipoprotein cholesterol ratio (THR) in carotid stenosis severity among AIS patients.
- To evaluate the clinical utility of THR in risk assessment and therapeutic decision-making for AIS patients with carotid stenosis.
Main Methods:
- 180 AIS patients with carotid stenosis were grouped by severity (mild, moderate, severe) and compared to 180 healthy controls.
- Carotid stenosis was diagnosed and graded using digital subtraction angiography.
- Total cholesterol to high-density lipoprotein cholesterol ratio (THR) and lipid profiles were analyzed within 24 hours of admission; statistical analyses included ANOVA, ROC curve, and multivariate regression.
Main Results:
- THR levels were significantly higher in AIS patients compared to controls (3.80 ± 1.07 vs 3.02 ± 0.67, p < 0.05).
- THR showed a positive correlation with carotid stenosis severity (p < 0.05).
- ROC analysis indicated robust diagnostic accuracy (AUC: 0.807), with a THR cutoff of 4.15 demonstrating 81.1% sensitivity and 95.6% specificity for severe stenosis.
Conclusions:
- The total cholesterol to high-density lipoprotein cholesterol ratio (THR) is a valuable, independent biomarker for assessing carotid stenosis severity in AIS.
- THR is a cost-effective tool that can enhance risk stratification and guide personalized care for AIS patients.
- Clinical application of THR can improve patient management and outcomes in acute ischemic stroke.
Abstract:
BackgroundThis study aims to investigate the role of the total cholesterol to high-density lipoprotein cholesterol ratio (THR) in predicting carotid stenosis in patients with acute ischemic stroke (AIS), aiming to establish its clinical utility in risk assessment and therapeutic decision-making.Methods180 patients with AIS and concomitant carotid stenosis were classified into three groups (classified as mild [<50%], moderate [50-70%], or severe [≥70%]) based on stenosis severity. These groups were compared to 180 healthy controls. Carotid stenosis was diagnosed in all participants using digital subtraction angiography, with the severity graded accordingly. THR and lipid profiles were analyzed within 24 h of admission. Statistical analyses included ANOVA, ROC curve evaluation, and multivariate regression to determine THR's predictive performance for stenosis severity.ResultsTHR levels were significantly elevated in AIS patients versus controls (3.80 ± 1.07 vs 3.02 ± 0.67; p < 0.05) and correlated with stenosis severity (mild: 3.22 ± 0.85; moderate:3.86 ± 0.91; severe: 4.33 ± 1.16; p < 0.05). ROC analysis demonstrated robust diagnostic accuracy (AUC: 0.807; 95% CI: 0.744-0.870), with a cutoff of 4.15 yielding 81.1% sensitivity and 95.6% specificity for severe stenosis.ConclusionsTHR is a cost-effective, independent biomarker for carotid stenosis severity in AIS; its clinical use improves risk stratification and guides personalized care.
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