LDL-C/HDL-C is associated with ischaemic stroke in patients with non-valvular atrial fibrillation: a case-control study

Abstract

Background: This study explored the relationships between the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and other clinical indicators and ischaemic stroke (IS) in patients with non-valvular atrial fibrillation (NVAF) in Xinjiang. The findings could provide a theoretical and therapeutic basis for NVAF patients.Methods: NVAF patients who were admitted to 10 medical centres across Xinjiang were divided into stroke (798 patients) and control (2671 patients) groups according to the occurrence of first acute IS occurred. Univariate and multivariate logistic regression analysis were used to examine the independent risk factors for IS in NVAF patients. Factor analysis and principal component regression analysis were used to analyse the main factors influencing IS. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminatory ability of LDL-C/HDL-C for predicting the occurrence of IS.Results: The stroke group had an average age of 71.64 ± 9.96 years and included 305 females (38.22%). The control group had a mean age of 67.30 ± 12.01 years and included 825 females (30.89%). Multivariate logistic regression showed that the risk of IS in the highest LDL-C/HDL-C quartile ( ≥2.73) was 16.23-fold that of the lowest quartile ( < 1.22); IS risk was 2.27-fold higher in obese patients than in normal-weight subjects; IS risk was 3.15-fold higher in smoking patients than in non-smoking patients. The area under the ROC curve of LDL-C/HDL-C was 0.76, the optimal critical value was 2.33, the sensitivity was 63.53%, and the specificity was 76.34%. Principal component regression analysis showed that LDL-C/HDL-C, age, smoking, drinking, LDL-C and hypertension were risk factors for IS in NVAF patients.Conclusions: LDL-C/HDL-C >1.22, smoking, BMI ≥24 kg/m2 and CHA2DS2-VASc score were independent risk factors for IS in NVAF patients; LDL-C/HDL-C was the main risk factor.

Capsaicin combined with dietary fiber prevents high‐fat diet associated aberrant lipid metabolism by improving the structure of intestinal flora

“…Four blood lipids—TC, TG, LDL‐C, and HDL‐C—are important indicators used to reveal changes in blood lipids (Chen et al, 2021). Earlier studies showed that HDL‐C levels negatively correlate with carotid atherosclerosis progression (Hedayatnia et al, 2020; Teis et al, 2021), while higher LDL‐C levels and lower HDL‐C levels might correlate with cardiovascular diseases (CVDs) such as stroke (Zhang, Wei, et al, 2020). This LDL‐C/HDL‐C ratio was proved to be more valuable than any single lipid component—especially LDL‐C—to predict CVDs risk (Hedayatnia et al, 2020; Zhang, Wei, et al, 2020).…”

Lipid Profile and Atrial Fibrillation: Is There Any Link?

“…Among individuals over 75, the incidence rate of AF was negatively correlated with LDL-C/HDL-C ratio (RR = 0.75, 95% CI 0.61-0.94) [29]. A Chinese case-control study of 3469 patients revealed that compared with the lowest LDL-C/HDL-C quartile, the occurrence risk of ischemic stroke (IS) was 16.23-fold that of highest quartile in patients with non-valvular AF (NVAF) [56]. As with the Multi-Ethnic Study of Atherosclerosis (MESA) and the Framing-ham Heart Study, compared with HDL-C <40 mg/dL, high levels of HDL-C for ≥60 mg/dL were related to lower risk of AF (adjusted HR 0.64, 95% CI 0.48-0.87), while higher TG levels was correlated with higher AF risk in those with levels ≥200 mg/dL versus <150 mg/dL (adjusted HR 1.60, 95% CI 1.25-2.05) [34].…”