Abstract | Background and Purpose: Methods: In this prospective multicenter cohort study, 10 499 consecutive acute ischemic stroke and transient ischemic attack patients with levels of LDL-C and hsCRP were enrolled. Patients were divided into 4 groups: residual cholesterol risk only ( LDL-C ≥2.6 mmol/L and hsCRP <3 mg/L), residual inflammatory risk (RIR) only ( LDL-C <2.6 mmol/L and hsCRP ≥3 mg/L), both risk ( LDL-C ≥2.6 mmol/L and hsCRP ≥3 mg/L), and neither risk ( LDL-C <2.6 mmol/L and hsCRP <3 mg/L). The primary outcomes consisted of stroke recurrence and a modified Rankin Scale score of 2 to 6 within 1 year. Results: The relative proportions of patients with RIR only, residual cholesterol risk only, both risk, and neither were 21.3%, 23.7%, 14.4%, and 40.6%, respectively. RIR only was independently associated with recurrent stroke (adjusted hazard ratio, 1.18 [95% CI, 1.00–1.40]; P=0.05). The association was slightly attenuated after further adjusting for usage of antiplatelet agent and statin during 1-year follow-up in addition to the traditional risk factors (hazard ratio, 1.31 [95% CI, 0.99–1.76]; P=0.07). When applying the LDL-C cutoff value of 1.8 mmol/L in the sensitivity analyses, such association in large-artery atherosclerosis subtype was more significant (adjusted hazard ratio, 1.69 [95% CI, 1.06–2.67]; P=0.03). Patients with RIR only also had increased risk of poor functional outcome (adjusted odds ratio, 1.43 [95% CI, 1.24–1.64]; P<0.0001). Conclusions:
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Authors | Jiejie Li, Yuesong Pan, Jie Xu, Shiyu Li, Mengxing Wang, Kehua Quan, Xia Meng, Hao Li, Jinxi Lin, Yilong Wang, Xingquan Zhao, Liping Liu, Yongjun Wang, CNSR-III Investigators |
Journal | Stroke
(Stroke)
Vol. 52
Issue 9
Pg. 2827-2836
(08 2021)
ISSN: 1524-4628 [Electronic] United States |
PMID | 34281380
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers
- Platelet Aggregation Inhibitors
- C-Reactive Protein
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Topics |
- Aged
- Biomarkers
(analysis)
- Brain Ischemia
(complications, diagnosis)
- C-Reactive Protein
(metabolism)
- Cohort Studies
- Female
- Humans
- Inflammation
(complications)
- Ischemic Attack, Transient
(complications, diagnosis)
- Ischemic Stroke
(complications, diagnosis)
- Male
- Middle Aged
- Platelet Aggregation Inhibitors
(pharmacology)
- Risk Factors
- Stroke
(complications, diagnosis, etiology)
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