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09 August 2019 : Clinical Research  

Association Between Low-Density Lipoprotein Cholesterol (LDL-C) Level and Unfavorable Outcomes in Participants of Ischemic Stroke without Diabetes: A Multi-Center Retrospective Study

Shan Zhao1ABCEF, Yuanmeng Tian2CD, Han Yan2EF, Boqiang Zhang2BC, Jing Li2CDE, Liying Xing2AEFG, Lei Liu3ACEF*

DOI: 10.12659/MSM.917798

Med Sci Monit 2019; 25:5934-5941

Abstract

BACKGROUND: The impact of low-density lipoprotein cholesterol (LDL-C) levels on outcomes in patients with non-diabetic acute ischemic stroke remains uncertain. The objective of this study was to explore whether LDL-C could refine outcomes after acute ischemic stroke in patients with non-diabetic acute ischemic stroke.

MATERIAL AND METHODS: A multi-center, retrospective, clinical-based study was conducted within eight hospitals between January 2015 and August 2016. Adjusted odds ratio (aOR) was used for measurement of unfavorable outcome which was evaluated by the modified Rankin Scale (mRS) score at 6 months after acute ischemic stroke, estimated categorically according to multivariate logistic regression.

RESULTS: A total of 1614 participants with non-diabetic acute ischemic stroke were enrolled, of which 376 patients (23.3%) had unfavorable neurologic outcomes at 6 months. After multivariate analysis comparing 4 LDL-C levels by quartiles (Q), we found that compared to Q1 (LDL-C level ≤2.41 mmol/L), there was a significant association between the frequency of unfavorable outcomes and levels of LDL-C (Q3: 2.95–3.54 mmol/L) for all participants (adjusted odds ratio [aOR]=0.63; 95% CI: 0.44–0.92, P=0.016) and patients with first ever strokes (aOR=0.52; 95% CI: 0.31–0.87, P=0.013).

CONCLUSIONS: Compared to lower LDL-C levels, non-diabetic patients with LDL-C levels in Q3 (2.95–3.54 mmol/L), were less likely to have unfavorable functional outcomes at 6 months after acute ischemic stroke. Managing HDL-C is one of the most important steps for the recovery of acute ischemic stroke.

Keywords: Brain Ischemia, Lipoproteins, LDL, Neurodegenerative Diseases, Retrospective Studies, Aged, Aged, 80 and over, China, Cholesterol, LDL, Logistic Models, Middle Aged, Multivariate Analysis, Odds Ratio, Prognosis, Risk Factors, Stroke, Treatment Outcome

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750