High ApoB/ApoA-I Ratio Predicts Post-Stroke Cognitive Impairment in Acute Ischemic Stroke Patients with Large Artery Atherosclerosis

Author:

Lee Minwoo12ORCID,Lim Jae-Sung3,Kim Yerim4ORCID,Park Soo Hyun4,Lee Sang-Hwa5ORCID,Kim Chulho5ORCID,Lee Byung-Chul1ORCID,Yu Kyung-Ho1,Lee Jae-Jun2,Oh Mi Sun1

Affiliation:

1. Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang 14068, Republic of Korea

2. Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon 24252, Republic of Korea

3. Department of Neurology, Asan Medical Center, Ulsan University College of Medicine, Seoul 05505, Republic of Korea

4. Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 24252, Republic of Korea

5. Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24252, Republic of Korea

Abstract

Background: We aimed to investigate the association between the ApoB/ApoA-I ratio and post-stroke cognitive impairment (PSCI) in patients with acute stroke of large artery atherosclerosis etiology. Methods: Prospective stroke registry data were used to consecutively enroll patients with acute ischemic stroke due to large artery atherosclerosis. Cognitive function assessments were conducted 3 to 6 months after stroke. PSCI was defined as a z-score of less than −2 standard deviations from age, sex, and education-adjusted means in at least one cognitive domain. The ApoB/ApoA-I ratio was calculated, and patients were categorized into five groups according to quintiles of the ratio. Logistic regression analyses were performed to assess the association between quintiles of the ApoB/ApoA-I ratio and PSCI. Results: A total of 263 patients were included, with a mean age of 65.9 ± 11.6 years. The median NIHSS score and ApoB/ApoA-I ratio upon admission were 2 (IQR, 1–5) and 0.81 (IQR, 0.76–0.88), respectively. PSCI was observed in 91 (34.6%) patients. The highest quintile (Q5) of the ApoB/ApoA-I ratio was a significant predictor of PSCI compared to the lowest quintile (Q1) (adjusted OR, 3.16; 95% CI, 1.19–8.41; p-value = 0.021) after adjusting for relevant confounders. Patients in the Q5 group exhibited significantly worse performance in the frontal domain. Conclusions: The ApoB/ApoA-I ratio in the acute stage of stroke independently predicted the development of PSCI at 3–6 months after stroke due to large artery atherosclerosis. Further, a high ApoB/ApoA-I ratio was specifically associated with frontal domain dysfunction.

Funder

National Research Foundation

Korean government

Research of Korea Centers for Disease Control and Prevention

Publisher

MDPI AG

Subject

Food Science,Nutrition and Dietetics

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