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

Journal：european journal of neurology

Publication type: Oeiginal Article

IF(IF): 6.089

PMID: 31002203 Link To Pubmed Full text Download

Stroke is a worldwide healthcare problem. In China, stroke was one of the leading causes of death and disability, of which 80% was ischemic stroke[1, 2]. Histological studies regarding carotid plaques morphology proposed the concept of the “vulnerable plaque”， which represented unstable and rupture-prone lesions. Vulnerable plaque was defined as anechogenic or heterogeneous plaque, or a plaque with irregular or ulcerative surface[3]. Disruption of unstable carotid plaques with subsequent thromboembolisms is believed to be one of the major causes of ischemic stroke[4]. Therefore, early finding and intervention the risk factors for vulnerable carotid plaques have been a key goal for prevention of ischemic stroke. Although the importance of cholesterol has been already known, the significant role of non-HDL-C in the formation and development of carotid atherosclerosis has come into view[5]. Non-HDL-C is the sum of atherogenic particles in plasma [very low-density lipoprotein cholesterol + intermediate density lipoprotein cholesterol + low-density lipoprotein cholesterol], which closely relates to atherogenic apolipoprotein B (Apo B). Compared with LDL-C, non-HDL-C is a better risk estimation indicator, particularly in patients with diabetes mellitus, higher level of triglycerides and the metabolic syndrome[6]. Recent researches suggest non-HDL-C has been considered as a secondary target for atherosclerotic cardiovascular disease[7]. The role of non-HDL-C in carotid atherosclerosis has been more concerned more[8-10]. Some studies investigated associations between lipid parameters (including non-HDL-C) and carotid plaques or intima-media thickness[8, 10-12]. However, few studies have assessed the association between plasma non-HDL-C level and the risk of vulnerable carotid plaques. Our study was designed to investigate the impact of plasma non-HDL-C level on the prevalence of asymptomatic vulnerable carotid plaques, and screen the risk factors for asymptomatic vulnerable carotid plaques to prevent ischemic stroke at an early stage.

Logistic regression to assess associations between the presence of vulnerable carotid plaques and non-HDL-C levels and calculated odds rates and 95% confidence intervals. Multivariate models adjust for age, sex, BMI, hypertension, diabetes mellitus, smoking, TG and HDL-C