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Relation of Low-Density Lipoprotein Cholesterol to Ischemic Stroke in Patients With Nonvalvular Atrial Fibrillation.

Abstract
Low-density lipoprotein cholesterol (LDL-C) has been demonstrated as an independent risk factor of ischemic stroke, but the association of LDL-C with ischemic stroke in patients with nonvalvular atrial fibrillation (AF) remains uncertain. Our objective was to explore whether LDL-C could refine stroke stratification in patients with AF. A total of 424 nonvalvular patients with AF with ischemic stroke and 391 ones without ischemic stroke were enrolled. No patient had received antithrombotic therapy. Multivariate logistic regression analysis showed that LDL-C was an independent predictor of ischemic stroke in patients with AF, with the adjusted odds ratio of 2.004 (95% confidence interval 1.624 to 2.473; p <0.001). The receiver operating characteristic analysis revealed that the best cut-off value of LDL-C to predict ischemic stroke in patients with AF was 2.48 mmol/L with 56.3% sensitivity and 66.3% specificity (area under the curve: 0.651, p <0.001). In the subgroup analysis based on different CHA2DS2-VASc scores, the predictive value of LDL-C remained significant in patients with a CHA2DS2-VASc score of ≤5. In conclusion, LDL-C was an independent predictor of ischemic stroke, which could potentially refine stroke stratification in patients with AF. A prospective study with a large number of patients is required to validate the current findings.
AuthorsZhiyong Qi, Hua Chen, Zhichao Wen, Fei Yuan, Huanchun Ni, Wen Gao, Jun Shen, Jian Li, Yangyi Lin, Ying Shan, Bo Jin, Pingping Yan, Haiming Shi, Xinping Luo
JournalThe American journal of cardiology (Am J Cardiol) Vol. 119 Issue 8 Pg. 1224-1228 (04 15 2017) ISSN: 1879-1913 [Electronic] United States
PMID28215412 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2017 Elsevier Inc. All rights reserved.
Chemical References
  • Cholesterol, LDL
  • Cholesterol
Topics
  • Aged
  • Atrial Fibrillation (blood)
  • Case-Control Studies
  • Cholesterol (blood)
  • Cholesterol, LDL (blood)
  • Female
  • Humans
  • Male
  • Multivariate Analysis
  • ROC Curve
  • Risk Factors
  • Sensitivity and Specificity
  • Stroke (blood)

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