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

• Published in: Scientific reports Vol. 14; no. 1; pp. 22794 - 10
• Main Authors: Kim, Hyunsoo, Kim, Joon-Tae, Lee, Ji Sung, Kim, Beom Joon, Kang, Jihoon, Lee, Keon-Joo, Park, Jong-Moo, Kang, Kyusik, Lee, Soo Joo, Kim, Jae Guk, Cha, Jae-Kwan, Kim, Dae-Hyun, Park, Tai Hwan, Lee, Kyungbok, Lee, Jun, Hong, Keun-Sik, Cho, Yong-Jin, Park, Hong-Kyun, Lee, Byung-Chul, Yu, Kyung-Ho, Oh, Mi Sun, Kim, Dong-Eog, Choi, Jay Chol, Kwon, Jee-Hyun, Kim, Wook-Joo, Shin, Dong-Ick, Yum, Kyu Sun, Sohn, Sung Il, Hong, Jeong-Ho, Lee, Sang-Hwa, Park, Man-Seok, Ryu, Wi-Sun, Park, Kwang-Yeol, Lee, Juneyoung, Saver, Jeffrey L., Bae, Hee-Joon
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.10.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/163; 692/617; Acute ischemic stroke; Aged; Aged, 80 and over; Cerebral infarction; Cholesterol, LDL - blood; Female; High density lipoprotein; Humanities and Social Sciences; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Ischemia; Ischemic Stroke - blood; Ischemic Stroke - drug therapy; LDL-cholesterol; LDL/HDL ratio; Lipid ratio; Lipids; Lipids - blood; Low density lipoprotein; Male; Middle Aged; multidisciplinary; Myocardial infarction; Myocardial Infarction - blood; Myocardial Infarction - drug therapy; Myocardial Infarction - mortality; Non-traditional lipid profiles; Prospective Studies; Registries; Risk Factors; Science; Science (multidisciplinary); Statins; Stroke; Stroke - blood; Stroke - drug therapy; Vascular outcome; LDL-cholesterol; Non-traditional lipid profiles; Acute ischemic stroke; Lipid ratio; Residual cardiovascular risk; LDL/HDL ratio; Vascular outcome
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-73851-5

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.