Association of LDL-C/HDL-C Ratio With Stroke Outcomes Within 1 Year After Onset: A Hospital-Based Follow-Up Study

I can really see absolutely no use for this. Recovery prediction is one of the stroke research topics that should never occur. It assumes the status quo in stroke stays the same. Well, that rehab status quo IS A COMPLETE FUCKING FAILURE!

Association of LDL-C/HDL-C Ratio With Stroke Outcomes Within 1 Year After Onset: A Hospital-Based Follow-Up Study

Li Liu^1,2, Ping Yin^1,2, Chong Lu^1,2, Jingxin Li^1,2, Zhaoxia Zang^1,2, Yongdan Liu^1,2, Shuang Liu^1,2 and Yafen Wei^1,2*

• ¹Department of Neurology, Heilongjiang Provincial Hospital, Harbin, China
• ²Department of Neurology, Heilongjiang Provincial Hospital Affiliated to Harbin Institute of Technology, Harbin, China

Stroke remains a leading cause of death and disability. The low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C ratio) ratio has been confirmed to be a predictor of stroke. However, few studies have assessed the prognostic impact of the LDL-C/HDL-C ratio for stroke patients. We aimed to investigate the relationship between the LDL-C/HDL-C ratio and the prognosis following stroke in Chinese patients. A total of 3,410 patients who had experienced their first ischemic stroke was recruited to this study within 72 h of stroke onset. The patients were followed for at least 12 months. A multivariate regression analysis was used to assess the association between the LDL-C/HDL-C ratio and prognosis following stroke. We considered the LDL-C/HDL-C ratio as a continuous variable and stratified patients according to the LDL-C/HDL-C ratio quartile. A higher LDL-C/HDL-C ratio was associated with lower rates of death, recurrence, and moderate disability (defined as a modified Rankin scale score >2) at 3 months. Using group 1 as the reference group, the relative risk (RRs) at 3 months for death were 0.45 (95% confidence interval [CI]: 0.27, 0.77) for group 2, 0.58 (95% CI: 0.34, 0.98) for group 3, and 0.97 (95% CI: 0.60, 1.56) for group 4; for recurrence, the RRs were 0.75 (95% CI: 0.56, 0.99) for group 2, 0.65 (95% CI: 0.48, 0.89) for group 3, and 0.55 (95% CI: 0.39, 0.78) for group 4; and for moderate disability, the RRs were 0.74 (95% CI: 0.55, 0.99) for group 2, 0.65 (95% CI: 0.47, 0.89) for group 3, and 0.55 (95% CI: 0.39, 0.77) for group 4. At 12 months, patients in group 2 were the most protected against ischemic stroke death (RR: 0.57; 95% CI: 0.34, 0.95). However, there were no associations between the LDL-C/HDL-C ratio and stroke recurrence or moderate disability. A higher LDL-C/HDL-C ratio was found to protect against death, recurrence, and moderate disability at 3 months. However, there was no significant association between the LDL-C/HDL-C ratio and stroke recurrence or moderate disability at 12 months. These results nonetheless suggest that a higher LDL-C/HDL-C ratio was associated with short-term stroke prognosis.

Introduction

Over the past few decades, stroke has been a leading cause of death and long-term disability, accounting for more than 4% of direct medical expenditures in developed countries (1–3). In China, stroke was the leading cause of death and disability from 1990 to 2017 (4), and almost one-third of the total number of deaths attributable to stroke worldwide occurred in China (5, 6). The economic burden of stroke in China is as high as ¥52 billion per year and mostly comprises long-term post-stroke treatment costs (4, 7). With the increase in life expectancy, disability caused by stroke has seriously hindered social mobility, economic progress, and improvement of living standards for older adults (8). Therefore, it is vital to determine the risk factors that affect prognosis following stroke and to implement treatments to reduce the incidence of new ischemic events.

Increasing evidence points to the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C ratio) ratio as a novel indicator of the risks of both atherosclerotic cardiovascular and cerebrovascular diseases, as it simultaneously takes into account both LDL-C and HDL-C levels (9, 10). A high LDL-C/HDL-C ratio is associated with cardiovascular events (11, 12). Meanwhile, low levels of HDL-C also have a significant impact on prognosis following cerebrovascular diseases (13–16). However, few studies have described the relationship between stroke prognosis and the LDL-C/HDL-C ratio, especially in China. Thus, we aimed to assess the association between the LDL-C/HDL-C ratio and the 12-month prognosis following acute ischemic stroke in China.