Oxidative Lipoprotein Markers Predict Poor Functional Outcome in Patients with Minor Stroke or Transient Ischemic Attack.

BACKGROUND AND PURPOSE: Oxidative stress plays an important role in acute ischemic stroke. However, the association of oxidative lipoprotein markers, including oxidized low-density lipoprotein (oxLDL), oxLDL/ high density lipoprotein (HDL), and oxLDL/ low density lipoprotein (LDL), with functional outcome of minor stroke or transient ischemic attack (TIA) remains unclear. We aimed to investigate the association between oxidative lipoprotein markers and poor functional outcome in patients with minor stroke or TIA.

METHODS: All patients with minor stroke or TIA were recruited from the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events (CHANCE) trial. The poor functional outcome included modified Rankin Scale (mRS) 2-6 and 3-6 at 90-day and 12-month follow-up. Multivariate logistic regression were used to investigate the associations of oxLDL, oxLDL/HDL, and oxLDL/LDL with poor functional outcome.

RESULTS: Among 3019 patients included in this study, the median (interquartile range) of oxLDL, oxLDL/HDL, and oxLDL/LDL were 13.96 (6.65-28.81) ug/dL, 4.52 (2.08-9.32), and 11.73 (5.27-24.85), respectively. After adjusted for confounding factors, patients in the highest oxLDL quartile had a higher proportion of mRS 2-6 at 90 days (HR, 1.78; 95% CI, 1.26-2.52) and 12 months (HR, 1.42; 95% CI, 1.01-1.99), mRS 3-6 at 90 days (HR, 1.98; 95% CI, 1.29-3.04) and 12 months (HR, 1.77; 95% CI, 1.09-2.89), when compared to the lowest oxLDL quartile (P< 0.05). Similar results were found for oxLDL/HDL and oxLDL/LDL.

CONCLUSIONS: Higher levels of oxidative lipoprotein markers are independent predictors of poor functional outcome in patients with minor stroke or TIA at 90 days and 12 months. This article is protected by copyright. All rights reserved.