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Association between high-density lipoprotein cholesterol to apolipoprotein A-1 ratio and the outcome of ischemic
Linyan Li1,2, Huiming Deng1,2, Zhiyao Xu3
1The Clinical Medicine, North Sichuan Medical College, Nanchong, China.
Insights
The high-density lipoprotein cholesterol (HDL-C)/apolipoprotein A-1 (APOA-1) ratio is linked to worse outcomes after ischemic stroke (IS). Elevated HDL-C/APOA-1 levels independently predict poor functional recovery at 3 months post-stroke.
Area of Science:
- Cardiology
- Neurology
- Biochemistry
Background:
- The high-density lipoprotein cholesterol (HDL-C)/apolipoprotein A-1 (APOA-1) ratio is a known risk factor for cardiovascular disease, cancer, and mortality.
- Limited data exist on the association between the HDL-C/APOA-1 ratio and outcomes in patients with ischemic stroke (IS).
Purpose of the Study:
- To investigate the association between the HDL-C/APOA-1 ratio and 3-month functional outcomes in patients who have experienced an ischemic stroke.
- To determine if the HDL-C/APOA-1 ratio is an independent predictor of poor functional recovery after IS.
Main Methods:
- Retrospective analysis of 674 patients with IS.
- Functional outcome assessed using the modified Rankin Scale (mRS) at 3 months.
- Logistic regression and restricted cubic splines used to analyze the correlation between HDL-C/APOA-1 ratio and outcomes, with subgroup analyses and assessment of predictive value.
Main Results:
- Patients with poor functional outcomes had a significantly higher HDL-C/APOA-1 ratio (0.99 ± 0.14) compared to those with good outcomes (0.94 ± 0.10).
- A higher HDL-C/APOA-1 ratio was an independent predictor of poor 3-month functional outcome (OR 1.50, P=0.003).
- The highest quartile of HDL-C/APOA-1 showed a 2.44-fold increased odds of poor outcome after adjustment for confounders.
Conclusions:
- Elevated HDL-C/APOA-1 ratio is independently associated with an increased risk of poor functional outcomes at 3 months in patients with ischemic stroke.
- The HDL-C/APOA-1 ratio may serve as a valuable prognostic biomarker for functional recovery after IS.
Background:
High-density lipoprotein cholesterol (HDL-C)/apolipoprotein A-1 (APOA-1) ratio has been identified as a risk factor for cardiovascular disease, cancer, and all-cause mortality. However, data related to ischemic stroke (IS) are lacking. We investigated whether the HDL-C/APOA-1 ratio was associated with 3-month functional outcome in patients with IS.
Methods:
A retrospective analysis was performed on 674 patients with IS. The 3-month functional outcome was classified as good or poor based on the modified Rankin Scale score (mRS). Logistic regression models (unadjusted and stepwise) were performed to evaluate the correlation between HDL-C/APOA-1 ratio and outcome. Restricted cubic splines evaluated nonlinear relationships, while subgroup analyses explored effect modifications. We assessed the added predictive value of the HDL-C/APOA-1 ratio by comparing nested models using the AUC, NRI, and IDI.
Results:
The HDL-C/APOA-1 level in the group with poor functional outcomes was higher than that in the group with good functional outcomes (0.99 ± 0.14 vs. 0.94 ± 0.10, p < 0.001). In the multivariable analysis, a higher HDL-C/APOA-1 ratio was identified as an independent factor associated with poor outcome at 3 months (OR 1.50, 95% CI:1.17-1.96, p = 0.003). The odds of poor outcome in the higher HDL-C/APOA-1 quartile increased by 2.44-fold (95% CI:1.30-4.64, p = 0.006) after adjusting for potential confounders compared to lower HDL-C/APOA-1 quartiles. In addition, multivariate-adjusted restricted cubic splines show a positive approach linear pattern of this association.
Conclusion:
Elevated HDL-C/APOA-1 is independently associated with an increased risk of poor functional outcomes at 3-month in patients with IS.
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