Remnant Cholesterol Key Risk Factor for Acute Ischemic Stroke: Study

A recent study published in the Journal of Stroke and Cerebrovascular Diseases highlighted the role of remnant cholesterol (RC) as a significant risk factor for acute ischemic stroke (AIS). Despite being recognized for its contribution to atherosclerosis, the exact link between RC and AIS has remained unclear until now. This research by Qian Feng and team determined whether fasting blood RC levels serve as an independent risk factor for AIS.

This comprehensive retrospective analysis examined a total of 650 patients diagnosed with AIS and 598 healthy control subjects and were observed during the same period. The team utilized binary logistic regression to explore the association between RC and AIS by employing Restricted Cubic Splines (RCS) to illustrate the link between RC levels and AIS risk.

The study revealed that RC levels were significantly higher in patients with AIS when compared to the healthy control group. Also, RC emerged as an independent risk factor for AIS even after adjusting for various covariates. For the RC concentrations below 0.69 mmol/L, the risk of AIS increased with rising RC levels which indicated a non-linear relationship in the RCS analysis. Also, at RC concentrations of 0.69 mmol/L or higher, the risk plateaued and became insignificant with further increases in RC.

Further analysis uncovered a marked association between RC and diabetes, as well as fasting glucose levels. Among diabetic patients, the incidence of AIS surged significantly with increased RC levels. Also, the RCS analysis highlighted that in diabetic patients, the risk of AIS increased continuously with RC levels above 1.15 mmol/L.

This study conclusively identifies RC as an independent risk factor for AIS by revealing a distinct non-linear association between RC levels and the risk of stroke. The findings illuminate the necessity for targeted AIS risk assessment strategies for diabetic patients who show an increased vulnerability to higher RC levels.

The researchers advocate for incorporating RC measurements into routine assessments for AIS risk stratification in populations with diabetes. This approach could lead to more personalized and effective prevention strategies by potentially reducing the incidence of AIS. Overall, this research highlights the pathogenic role of RC in AIS but also suggests that managing RC levels could be crucial in preventing strokes in diabetic individuals.

Source:

Feng, Q., Li, H., Zhang, R.-Y., Sun, L., Zhang, S.-Y., Chen, Y., Zhang, Y., Shan, B.-S., Zhao, Z., Zhou, H., & Xu, X. (2024). Elevated remnant cholesterol is a risk factor for acute ischemic stroke. In Journal of Stroke and Cerebrovascular Diseases (Vol. 33, Issue 8, p. 107773). Elsevier BV. https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.107773