Affiliation:
1. Department of Neurology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
Abstract
Background:
Oxidized Low-Density Lipoprotein (ox-LDL) is crucial in the recrudescence and
prognosis of acute ischemic stroke (AIS). We aimed to probe into the influence of cumulative ox-LDL exposure
on the 90-day prognosis of AIS.
Methods:
Patients with AIS were recruited in this research. AIS severity at admission was estimated with infarct
volumes and National Institute of Health Stroke Scale (NIHSS) scores. AIS prognosis was assessed using
Modified Rankin Scale (mRS) scores at 90 days and the change in NIHSS scores from admission to discharge.
Cumulative ox-LDL exposure was defined as ox-LDL level (pg/mL) multiplied by age(y). Multivariate logistic
regression analysis was employed to reveal the correlation between exposure factors and the prognosis of
AIS. The prognostic prediction ability of cumulative ox-LDL exposure was compared with cumulative LDL
exposure by the receiver operating characteristic curve (ROC).
Results:
Higher cumulative ox-LDL exposure was related to worse prognosis, including neurological worsening
at discharge (NIHSS increasing more than 2 points) (OR = 3.02, 95% CI, 1.30-6.98, P = 0.01) and poor
functional prognosis at 90 days (mRS ≥ 3) (OR = 21.21, 95% CI, 4.72-95.36, P < 0.001). As multivariate regression
analysis showed, significantly increased cumulative ox-LDL exposure was relevant to poor functional
prognosis at 90 days (OR = 9.92, 95% CI, 1.23-79.76, P = 0.031), but not with neurological worsening at
discharge (P = 0.414). ROC curve revealed that cumulative ox-LDL exposure had a higher predictive value
(AUC = 0.843, P < 0.001) for functional prognosis of AIS than cumulative LDL exposure(AUC = 0.629, P =
0.023).
Conclusion:
Cumulative ox-LDL exposure has a positive correlation with poor prognosis at 90 days of AIS,
and has a more accurate predictive ability than cumulative LDL exposure.
Funder
Enbipu Co., Ltd. of Shiyao Group
Shanghai Committee of Science and Technology
Publisher
Bentham Science Publishers Ltd.