Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2024 Oct 1;14(1):22794.
doi: 10.1038/s41598-024-73851-5.

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  1 , Joon-Tae Kim  2 , Ji Sung Lee  3 , Beom Joon Kim  4 , Jihoon Kang  4 , Keon-Joo Lee  5 , Jong-Moo Park  6 , Kyusik Kang  7 , Soo Joo Lee  8 , Jae Guk Kim  8 , Jae-Kwan Cha  9 , Dae-Hyun Kim  9 , Tai Hwan Park  10 , Kyungbok Lee  11 , Jun Lee  12 , Keun-Sik Hong  13 , Yong-Jin Cho  13 , Hong-Kyun Park  13 , Byung-Chul Lee  14 , Kyung-Ho Yu  14 , Mi Sun Oh  14 , Dong-Eog Kim  15 , Jay Chol Choi  16 , Jee-Hyun Kwon  17 , Wook-Joo Kim  17 , Dong-Ick Shin  18 , Kyu Sun Yum  18 , Sung Il Sohn  19 , Jeong-Ho Hong  19 , Sang-Hwa Lee  20 , Man-Seok Park  1 , Wi-Sun Ryu  21 , Kwang-Yeol Park  22 , Juneyoung Lee  23 , Jeffrey L Saver  24 , Hee-Joon Bae  25   26
Affiliations
Multicenter Study

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 et al. Sci Rep. .

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.

Keywords: Acute ischemic stroke; LDL-cholesterol; LDL/HDL ratio; Lipid ratio; Non-traditional lipid profiles; Residual cardiovascular risk; Vascular outcome.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan-Meier survival plots for 1-year primary outcome according to the LDL/HDL ratio, unadjusted (A) and adjusted plots (B).
Fig. 2
Fig. 2
Adjusted HR of continuous LDL/HDL ratio for primary outcome within 1 year.
Fig. 3
Fig. 3
Associations of LDL/HDL ratio with one-year vascular outcomes according to the ischemic stroke subtypes.
See this image and copyright information in PMC

References

    1. Cholesterol Treatment Trialists, C. et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet 380, 581–590 (2012). - PMC - PubMed
    1. Amarenco, P. et al. High-dose atorvastatin after stroke or transient ischemic attack. N. Engl. J. Med. 355, 549–559. 10.1056/NEJMoa061894 (2006). - PubMed
    1. Amarenco, P. et al. A comparison of two LDL cholesterol targets after ischemic stroke. N. Engl. J. Med. 382, 9. 10.1056/NEJMoa1910355 (2020). - PubMed
    1. Nesto, R. W. Beyond low-density lipoprotein: addressing the atherogenic lipid triad in type 2 diabetes mellitus and the metabolic syndrome. Am. J. Cardiovasc. Drugs 5, 379–387. 2005/11/02 (2005). - PubMed
    1. Di Giorgi, N. et al. A specific plasma lipid signature associated with high triglycerides and low HDL cholesterol identifies residual CAD risk in patients with chronic coronary syndrome. Atherosclerosis 339, 1–11. 10.1016/j.atherosclerosis.2021.11.013 (2021). - PubMed

Publication types

Substances