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05-01-2024 | Stroke

Effects of elevated remnant cholesterol on outcomes of acute ischemic stroke patients receiving mechanical thrombectomy

Authors: Mengmeng Li, Meng Wang, Yixin Zhao, Rui Zhong, Wanying Chen, Xiangyu Lei, Xiaoyu Wu, Jiaxin Han, Lei Lei, Qingfan Wang, Guogang Luo, Meng Wei

Published in: Journal of Thrombosis and Thrombolysis | Issue 3/2024

Abstract

Objective: Large cohort studies provided evidence that elevated remnant cholesterol (RC) was an important risk factor for ischemic stroke. However, the association between high RC and clinical outcomes in acute ischemic stroke (AIS) individuals was still undetermined. Methods: This retrospective study enrolled 165 AIS patients undergoing mechanical thrombectomy in one tertiary stroke center. We divided patients into two groups based on the median of their RC levels (0.49 mmol/L). The modified Rankin Scale (mRS) was used to evaluate the primary outcome 90 days after the onset of symptoms. The mRS scores ≤ 2 and ≤ 1 at 90 days were deemed as favorable and excellent outcomes, respectively. Results: In the overall AIS patients undergoing mechanical thrombectomy, there was no obvious distinction between the high and low RC group at 90-day favorable outcome (41.0% vs. 47.1%, P = 0.431) or excellent outcome (23.1% vs. 31.0%, P = 0.252). In the subgroup analysis stratified by stroke etiology, non-large artery atherosclerosis (non-LAA) stroke patients yielded with less favorable or excellent prognosis in the high RC group (26.8% vs. 46.8%, adjusted OR = 0.31, 95%CI: 0.11–0.85, P = 0.023; or 12.2% vs. 29.0%, adjusted OR = 0.18, 95%CI: 0.04–0.80, P = 0.024, respectively.). Post hoc power analyses indicated that the power was sufficient for favorable outcome (80.38%) and excellent outcome (88.72%) in non-LAA stroke patients. Additionally, RC can enhance the risk prediction value of a poor outcome (mRS scores 3–6) based on traditional risk indicators (including age, initial NIHSS score, operative duration, and neutrophil-to-lymphocyte ratio) for non-LAA stroke patients (AUC = 0.86, 95%CI: 0.79–0.94, P < 0.001). Conclusion: In AIS patients undergoing mechanical thrombectomy, elevated RC was independently related to poor outcome for non-LAA stroke patients, but not to short-term prognosis of LAA stroke patients.

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Title: Effects of elevated remnant cholesterol on outcomes of acute ischemic stroke patients receiving mechanical thrombectomy
Authors: Mengmeng Li
Meng Wang
Yixin Zhao
Rui Zhong
Wanying Chen
Xiangyu Lei
Xiaoyu Wu
Jiaxin Han
Lei Lei
Qingfan Wang
Guogang Luo
Meng Wei
Publication date: 05-01-2024
Publisher: Springer US
Keywords: Stroke
Thrombectomy
Arterial Occlusive Disease
Published in: Journal of Thrombosis and Thrombolysis / Issue 3/2024
Print ISSN: 0929-5305
Electronic ISSN: 1573-742X
DOI: https://doi.org/10.1007/s11239-023-02939-y

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