Triglyceride-to-HDL Cholesterol Ratio Is Associated with Ischemic Stroke Risk in Patients-With Paroxysmal Atrial...

Area of Science:

• Cardiology
• Neurology
• Metabolic Syndrome

Background:

• Ischemic stroke is a major complication of atrial fibrillation (AF).
• Current clinical scores may not fully capture cardiometabolic risk factors for stroke in AF.
• The triglyceride-to-HDL cholesterol ratio (TG/HDLc) is a potential marker for atherogenic dyslipidemia and insulin resistance.

Purpose of the Study:

• To assess if TG/HDLc can predict ischemic stroke risk in patients with paroxysmal atrial fibrillation (PAF).
• To explore TG/HDLc's utility in complementing conventional risk scores like CHA2DS2-VA for stroke risk stratification in PAF.
• To characterize a metabolically high-risk phenotype in PAF patients.

Main Methods:

• Retrospective, single-center observational study of 1111 AF admissions, focusing on 349 with PAF.
• Patients stratified into two groups based on TG/HDLc ratio (>2.5 vs. <2.5).
• Statistical analyses included Chi-square, t-tests, Pearson correlations, Kaplan-Meier, Cox regression, and multivariable logistic regression.

Main Results:

• Patients with TG/HDLc > 2.5 showed a significantly higher prevalence of ischemic stroke (37.4% vs. 21.1%, p=0.0008) compared to those with TG/HDLc < 2.5.
• Elevated TG/HDLc was linked to a 68% higher hazard of first ischemic stroke (HR 1.68).
• Higher TG/HDLc was associated with greater cerebrovascular burden, including cortical atrophy and cerebral lacunarism.

Conclusions:

• The TG/HDLc ratio identifies a metabolically high-risk PAF phenotype.
• This phenotype is associated with increased cerebrovascular burden and reduced ischemic stroke-free survival.
• TG/HDLc serves as an inexpensive marker that may enhance conventional clinical risk scores for stroke prediction in PAF.