国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

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Non–High-Density Lipoprotein Cholesterol Predicts Adverse Outcomes in Acute Ischemic Stroke

第一作者：Guangyao Wang

通讯作者：Yongjun Wang and Yilong Wang

ischemic stroke lipids prognosis

基本信息

2021-05-18

已发表文章

发表杂志：Stroke

发表类型: Original Paper

影响因子(IF): 7.914

PMID: 34000828 Pubmed原文链接 全文下载

主要研究背景及目的

A recent study showed non-high-density lipoprotein cholesterol (non-HDL-C) concentrations in blood are strongly associated with long-term risk of atherosclerotic cardiovascular disease. In a disease free population, non-HDL-C baseline levels are significantly associated with the risk of ischemic stroke. Serum non-HDL-C level is a stronger predictor for the risk of ischemic stroke than serum low density lipoprotein cholesterol (LDL-C) level in the Chinese population.3 Higher non-HDL-C and triglyceride (TG) to (HDL-C) ratio (TG/HDL-C) were strongly associated with death in acute ischemic stroke.4 However, the association of non-HDL-C concentrations and TG/HDL -C in blood with outcomes of ischemic stroke or TIA is unclear. Using data from the Intervention to Bridge the Evidence-based Gap in Stroke Care Quality (GOLDEN BRIDGE—AIS), we estimated the outcomes of ischemic stroke and TIA with non-HDL-C concentrations and TG/HDL -C.

方法

Among 19 604 patients with acute ischemic stroke admitted to the China National Stroke Registry II, 16 113 with both total cholesterol and HDL-C were analyzed. Patients were classified into 5 groups by quintiles of non-HDL-C. The outcomes included recurrent ischemic stroke, intracranial hemorrhage, and all-cause death within 1 year. The relationship of non-HDL-C with the risk of outcomes was analyzed by Cox regression models.

结论

Non-HDL-C may be a qualified predictor for recurrent ischemic stroke and all-cause death within 1 year in patients with acute ischemic stroke

主要结果

Among the 16 113 patients, the median (interquartile range) of non-HDL-C was 3.41 (2.78–4.10) mmol/L. After adjustment for confounding variables, patients in the top quintile of non-HDL-C were associated with higher risk of recurrent ischemic stroke within 1 year (adjusted hazard ratio, 1.46 [95% CI, 1.20–1.77]), compared with those in the third quintile. Patients in the bottom and top quintile of non-HDL-C were associated with higher risk of all-cause death within 1 year (adjusted hazard ratio, 1.22 [95% CI, 1.01–1.47] and adjusted hazard ratio, 1.40 [95% CI, 1.15–1.70], respectively), compared with those in the third quintile. However, non-HDL-C levels were not significantly predictive in intracranial hemorrhage.