Higher levels of small dense LDL cholesterol robustly associated with increased risk of ischemic stroke

For decades it has been suggested that small dense low-density lipoprotein (sdLDL) may be particularly atherogenic. High levels of small dense low-density lipoprotein are associated with an increased risk of ischemic heart disease; however, the association of small dense low-density lipoprotein (LDL) with ischemic stroke has not been explored in a large prospective study on the general population. We tested the hypothesis that high small dense low-density lipoprotein (LDL) cholesterol levels are associated with an increased risk of ischemic stroke.

This prospective study included 38,319 individuals from the Copenhagen General Population Study with fresh sample measurements of sdLDL cholesterol. Median follow-up time was 3.1 years. We observed 302 and 74 ischemic and haemorrhagic strokes from baseline in 2013-2017 to end of follow-up in 2018. They included estimates for large buoyant LDL cholesterol and total LDL cholesterol for comparison.

Reference:

Balling, M., Nordestgaard, B.G., Varbo, A., Langsted, A., Kamstrup, P.R. and Afzal, S. (2023), Small dense LDL cholesterol and ischemic stroke. Ann Neurol. Accepted Author Manuscript. https://doi.org/10.1002/ana.26598