The total cholesterol to high-density lipoprotein cholesterol as a predictor of poor outcomes in a Chinese population with acute ischaemic stroke.

Abstract

BACKGROUND:

High admission cholesterol has been associated with better outcome after acute ischaemic stroke (AIS), but a paradox not completely illustrated. The purpose of this study was to investigate the effect of the total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) on short-term survival after AIS.

METHODS:

Consecutive patients admitted in 2013 and 2015 were enrolled in the present study. The logistic regression analysis was conducted to evaluate predictors of 3-month outcomes. The primary endpoint was death. Secondary endpoint was good (modified Rankin Scale score 0-2 or equal to prestrike modified Rankin Scale score) at 3 months.

RESULTS:

Of 871 patients enrolled in the final analysis, 94 (10.8%) individuals died during 3 months of observation. The serum TC and TC/HDL-C levels at admission were significantly associated with stroke outcomes at 3 months, and the HDL-C level was only correlated with the good outcomes at 3 months. Mortality risk was markedly decreased for patients with high TC/HDL-C ratio (odds ratio: 0.23, 95% confidence interval [CI]: 0.10-0.50 for Q4:Q1; P-trend <.001) after adjustment. The effect of TC/HDL-C ratio on the probability of good outcomes was still obvious (odds ratio: 2.18, 95% CI: 1.40-3.39 for Q4:Q1; P-trend=.029). According to the receiver operating characteristic analyses, the best discriminating factor was a TG/HDL-C ≥3.37 (area under the ROC curve [AUC]=0.643, sensitivity 61.3%, specificity 61.7%) as well as the TC/HDL-C ≥4.09 for good outcomes (AUC: 0.587, sensitivity 63.9%, specificity 79.7%).

CONCLUSIONS:

High TC/HDL-C ratio may be associated with increased short-term survival and better outcomes after AIS.

• Authors: Lifang Chen, Jianing Xu, Hao Sun, Hao Wu, Jinsong Zhang
• Journal: Journal of clinical laboratory analysis (J Clin Lab Anal) Vol. 31 Issue 6 (Nov 2017) ISSN: 1098-2825 [Electronic] United States
• PMID: 28124804 (Publication Type: Journal Article)
• Copyright: © 2017 Wiley Periodicals, Inc.

Chemical References

• Cholesterol, HDL
• Cholesterol

Topics

• Aged
• Aged, 80 and over
• China (epidemiology)
• Cholesterol (blood)
• Cholesterol, HDL (blood)
• Female
• Humans
• Male
• Middle Aged
• Predictive Value of Tests
• Prognosis
• ROC Curve
• Stroke (blood, epidemiology, mortality)
• Treatment Outcome