Like maybe a 307% stroke risk reduction from these 11 possibilities?
The SPARCL trial was designed to assess the predictive value of oxidized phospholipids on apolipoprotein B-100 (OxPL-apoB) levels, the efficacy of atorvastatin therapy and their relationship to recurrent stroke or first major CV event, the researchers wrote. The study evaluated whether patients who had prior cerebrovascular events and high levels of OxPL-apoB, but no prior CAD, are at elevated recurrent stroke risk and CAD events after high-dose statin therapy.
At baseline, the SPARCL trial measured levels of OxPL-apoB in 4,385 patients with stroke or TIA and in 3,106 patients at 5 years after randomization to placebo or 80 mg atorvastatin.
The primary endpoint was the time from randomization to second nonfatal or fatal stroke. Secondary endpoints included first major coronary events and any CV event.
Patients with recurrent stroke had higher median OxPL-apoB levels at baseline than patients without (15.5 nmol/L vs. 11.6 nmol/L; P < .0001).
After multivariable adjustment, elevated OxPL-apoB at baseline predicted recurrent stroke (HR = 4.3; P < .0001), first major coronary events (HR = 4; P < .0001) and any CV event (HR = 4.4; P < .0001). There was no difference by treatment in comparison for any endpoint, shown as a nonsignificant interaction test, according to the researchers.
There was a significant improvement in net reclassification improvement, integrated discrimination improvement and area under the receiver-operating characteristic curve (AUC) when OxPL-apoB was added to the models, with change in AUC of 0.0505 (P < .0001) for recurrent stroke, 0.0409 (P < .0001) for first major coronary event and 0.0791 (P < .0001) for any CV event.