Fan Haimei, Liu Tingting, Zhang Kaili, Wang Yongle, Wang Rong, Yang Fei, Chen Feifei, Zhang Yanli, Guo Huaai, Li Xinyi, Wu Xuemei, Niu Xiaoyuan
Department of Neurology, Sixth Hospital of Shanxi Medical University (General Hospital of Tisco).
Department of Neurology, First Hospital of Shanxi Medical University.
J Atheroscler Thromb. 2025 Feb 1;32(2):141-162. doi: 10.5551/jat.64987. Epub 2024 Sep 4.
We aimed to assess the association between non-high-density lipoprotein cholesterol (non-HDL-C) and symptomatic intracranial artery stenosis (sICAS), as well as the impact of non-HDL-C on recurrent vascular events in patients with mild ischemic stroke ( NIHSS score ≤ 5).
This prospective study was based on data from patients presenting within 72 hours of stroke occurrence. We included patients admitted to 8 Chinese hospitals between September 2019 and November 2021. The associations of non-HDL-C with sICAS and recurrent vascular risk were assessed using multivariate regression models and a restricted cubic spline analysis.
Among the 2,544 patients analyzed at 12 months, 652 (25.6%) were diagnosed with sICAS. Elevated non-HDL-C was linked to a higher incidence of sICAS, and the adjusted odd ratios for quintile variables and continuous variables were 1.36 ([95% CI, 1.01-1.81]) and 1.14 ([95% CI, 1.04-1.24). In comparison to those in the first quintile, the adjusted hazard ratio of the fifth quintile of non-HDL-C was 1.19 ([95% CI 0.78-1.80]) for recurrent ischemic stroke and was 0.39 ([95% CI, 0.17-0.91]) for intracranialhemorrhage.
The non-HDL-C level may be a useful predictor of sICAS. Higher non-HDL-C levels may be associated with a lower risk of intracranial hemorrhage in mild, noncardiogenic stroke, but not a higher risk of recurrent ischemic stroke.
我们旨在评估非高密度脂蛋白胆固醇（non-HDL-C）与症状性颅内动脉狭窄（sICAS）之间的关联，以及non-HDL-C对轻度缺血性卒中（美国国立卫生研究院卒中量表[NIHSS]评分≤5分）患者复发性血管事件的影响。
这项前瞻性研究基于卒中发生后72小时内就诊患者的数据。我们纳入了2019年9月至2021年11月期间在中国8家医院住院的患者。使用多变量回归模型和受限立方样条分析评估non-HDL-C与sICAS及复发性血管风险之间的关联。
在12个月时分析的2544例患者中，652例（25.6%）被诊断为sICAS。non-HDL-C升高与sICAS的发生率较高相关，五分位数变量和连续变量的校正比值比分别为1.36（[95%置信区间，1.01 - 1.81]）和1.14（[95%置信区间，1.04 - 1.24]）。与第一五分位数的患者相比，non-HDL-C第五五分位数的患者发生复发性缺血性卒中的校正风险比为1.19（[95%置信区间0.78 - 1.80]），发生颅内出血的校正风险比为0.39（[95%置信区间，0.17 - 0.91]）。
non-HDL-C水平可能是sICAS的一个有用预测指标。较高的non-HDL-C水平可能与轻度非心源性卒中患者颅内出血风险较低相关，但与复发性缺血性卒中风险较高无关。
