Effects of Elevated Remnant Cholesterol on Outcomes of Acute Ischemic Stroke Patients Receiving Mechanical Thrombectomy

Overview

Journal J Thromb Thrombolysis

Specialty Cardiology & Vascular Diseases

Date 2024 Jan 5

PMID 38180591

Authors

Mengmeng Li

Meng Wang

Yixin Zhao

Rui Zhong

Wanying Chen

Xiangyu Lei

Xiaoyu Wu

Jiaxin Han

Lei Lei

Qingfan Wang

Guogang Luo

Meng Wei

Affiliations

Soon will be listed here.

Abstract

Objective: Large cohort studies provided evidence that elevated remnant cholesterol (RC) was an important risk factor for ischemic stroke. However, the association between high RC and clinical outcomes in acute ischemic stroke (AIS) individuals was still undetermined.

Methods: This retrospective study enrolled 165 AIS patients undergoing mechanical thrombectomy in one tertiary stroke center. We divided patients into two groups based on the median of their RC levels (0.49 mmol/L). The modified Rankin Scale (mRS) was used to evaluate the primary outcome 90 days after the onset of symptoms. The mRS scores ≤ 2 and ≤ 1 at 90 days were deemed as favorable and excellent outcomes, respectively.

Results: In the overall AIS patients undergoing mechanical thrombectomy, there was no obvious distinction between the high and low RC group at 90-day favorable outcome (41.0% vs. 47.1%, P = 0.431) or excellent outcome (23.1% vs. 31.0%, P = 0.252). In the subgroup analysis stratified by stroke etiology, non-large artery atherosclerosis (non-LAA) stroke patients yielded with less favorable or excellent prognosis in the high RC group (26.8% vs. 46.8%, adjusted OR = 0.31, 95%CI: 0.11-0.85, P = 0.023; or 12.2% vs. 29.0%, adjusted OR = 0.18, 95%CI: 0.04-0.80, P = 0.024, respectively.). Post hoc power analyses indicated that the power was sufficient for favorable outcome (80.38%) and excellent outcome (88.72%) in non-LAA stroke patients. Additionally, RC can enhance the risk prediction value of a poor outcome (mRS scores 3-6) based on traditional risk indicators (including age, initial NIHSS score, operative duration, and neutrophil-to-lymphocyte ratio) for non-LAA stroke patients (AUC = 0.86, 95%CI: 0.79-0.94, P < 0.001).

Conclusion: In AIS patients undergoing mechanical thrombectomy, elevated RC was independently related to poor outcome for non-LAA stroke patients, but not to short-term prognosis of LAA stroke patients.

Citing Articles

Impact of remnant cholesterol on acute ischemic stroke prognosis: a nationwide cohort analysis stratified by non-alcoholic fatty liver disease status.

Jiang S, Jin A, Xing W, Jing J Front Neurol. 2025; 16:1472871.

PMID: 39949793 PMC: 11822771. DOI: 10.3389/fneur.2025.1472871.

Relationship between remnant cholesterol and short-term prognosis in acute ischemic stroke patients.

Tan Z, Zhang Q, Liu Q, Meng X, Wu W, Wang L Brain Behav. 2024; 14(5):e3537.

PMID: 38715443 PMC: 11077245. DOI: 10.1002/brb3.3537.

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