Impact of non-traditional lipid profiles on 1-year vascular outcomes in ischemic stroke patients with prior statin therapy and LDL-C < 100 mg/dL

Hyunsoo Kim, Joon Tae Kim, Ji Sung Lee, Beom Joon Kim, Jihoon Kang, Keon Joo Lee, Jong Moo Park, Kyusik Kang, Soo Joo Lee, Jae Guk Kim, Jae Kwan Cha, Dae Hyun Kim, Tai Hwan Park, Kyungbok Lee, Jun Lee, Keun Sik Hong, Yong Jin Cho, Hong Kyun Park, Byung Chul Lee, Kyung Ho YuMi Sun Oh, Dong Eog Kim, Jay Chol Choi, Jee Hyun Kwon, Wook Joo Kim, Dong Ick Shin, Kyu Sun Yum, Sung Il Sohn, Jeong Ho Hong, Sang Hwa Lee, Man Seok Park, Wi Sun Ryu, Kwang Yeol Park, Juneyoung Lee, Jeffrey L. Saver, Hee Joon Bae

Research output: Contribution to journalArticlepeer-review

Abstract

This study aimed to investigate the association between non-traditional lipid profiles and the risk of 1-year vascular events in patients who were already using statins before stroke and had admission LDL-C < 100 mg/dL. This study was an analysis of a prospective, multicenter, nationwide registry of consecutive patients with acute ischemic stroke patients who treated with statin before index stroke and LDL-C < 100 mg/dL on admission. Non-traditional lipid profiles including non-HDL, TC/HDL ratio, LDL/HDL ratio, and TG/HDL ratio were analyzed as a continuous or categorical variable. The primary vascular outcome within one year was a composite of recurrent stroke (either hemorrhagic or ischemic), myocardial infarction (MI) and all-cause mortality. Hazard ratios (95% Cis) for 1-year vascular outcomes were analyzed using the Cox PH model for each non-traditional lipid profiles groups. A total of 7028 patients (age 70.3 ± 10.8years, male 59.8%) were finally analyzed for the study. In unadjusted analysis, no significant associations were observed in the quartiles of LDL/HDL ratio and 1-year primary outcome. However, after adjustment of relevant variables, compared with Q1 of the LDL/HDL ratio, Q4 was significantly associated with increasing the risk of 1-year primary outcome (HR 1.48 [1.19–1.83]). For the LDL/HDL ratio, a linear relationship was observed (P for linearity < 0.001). Higher quartiles of the LDL/HDL ratio were significantly and linearly associated with increasing the risk of 1-year primary vascular outcomes. These findings suggest that even during statin therapy with LDL-C < 100 mg/dl on admission, there should be consideration for residual risk based on the LDL/HDL ratio, following stroke.

Original languageEnglish
Article number22794
JournalScientific Reports
Volume14
Issue number1
DOIs
StatePublished - Dec 2024

Keywords

  • Acute ischemic stroke
  • LDL-cholesterol
  • LDL/HDL ratio
  • Lipid ratio
  • Non-traditional lipid profiles
  • Residual cardiovascular risk
  • Vascular outcome

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