Small dense LDL-C predicts severity, calcification in acute ischaemic stroke patients

Small dense low-density lipoprotein cholesterol (sd-LDL-C) is a strong predictor of stroke severity and intracranial artery calcification (IAC) in patients with acute ischaemic stroke (AIS), a study has shown.

Researchers performed a cross-sectional analysis of 754 IS patients (mean age, 65±13.2 years; 515 males) who had undergone brain computed tomography angiography for the evaluation of IAC. A commercially available assay kit was used to measure serum sd-LDL-C and the National Institutes of Health Stroke Scale (NIHSS) score was calculated upon admission.

The average sd-LDL-C concentration of the overall cohort was 0.90±0.46 mmol/L. Partial correlation analysis, adjusted for age and sex, showed that sd-LDL-C was correlated with IAC (p=0.006) and the NIHSS score (p<0.001).

This was confirmed in linear logistic regression analysis, which found an independent and significant link between NIHSS score (β, 1.537, 95 percent confidence interval [CI], 0.134–2.878; p=0.042) and IAC score (β, 1.355, 95 percent CI, 0.319–2.446; p=0.015) with sd-LDL-C levels.

Severe calcification was defined as an IAC score >4. Sd-LDL-C levels were significantly elevated in patients with severe calcification (p<0.001). However, admission NIHSS scores and mortality rate did not differ according to calcification classification.

Moreover, sd-LDL-C appeared to pose a significant short-term mortality risk in AIS patients (odds ratio, 1.936, 95 percent CI, 1.134–3.306; p=0.016), though controlling for confounders attenuated this interaction.

Future studies are required to better determine the prognostic value of sd-LDL-C in AIS patients, the researchers said.