In patients with minor stroke or transient ischemic attack (TIA), elevated levels of oxidized low-density lipoprotein (oxLDL) may predict recurrent stroke risk within 90 days of stroke or TIA onset, according to a study published in Neurology.
A total of 3019 patients with either acute minor stroke or high-risk TIA were enrolled in the study. Blinded investigators collected data on plasma oxLDL levels at baseline. Stroke was determined by an National Institutes of Health Stroke Scale score of ≤3, and high-risk TIA was defined as an ABCD2 of ≥4. An incidence of stroke within a 90-day period of enrollment made up the primary outcome. Additional outcomes included any stroke within a 1-year period, as well as 90-day and 1-year ischemic stroke and combined vascular events.
At baseline, the median oxLDL levels were 13.96 (interquartile range, 6.65-28.81) μg/dL. In the adjusted analysis, the highest oxLDL quartile of ≥28.81 μg/dL was associated with a significantly greater risk for 90-day recurrent stroke vs those in the lowest oxLDL quartile of <6.65 μg/dL (hazard ratio, 1.43; 95% CI, 1.03-1.98). oxLDL held the strongest predictive value for 90-day recurrent stroke in patients who were not taking statin medications (hazard ratio, 1.92; 95% CI, 1.26-2.94). No associations were found between oxLDL levels and dual antiplatelet, antihypertensive, or antidiabetic agents.
A limitation of the analysis includes the reliance on questionnaire data to determine participants’ medical histories.
The finding that oxLDL is predictive of recurrent stroke “may be significant because there currently are no other biomarkers that can predict the risk of recurrent stroke.”
Wang A, Xu J, Chen G, et al. Oxidized low-density lipoprotein predicts recurrent stroke in patients with minor stroke or TIA. Neurology. 2018;91(10):e947-e955.