Abstract 187: Nontraditional Lipid Indices and Intracranial Atherosclerotic Stenosis Burden

Abstract

Introduction Expert consensus guidelines recommend low‐density lipoprotein cholesterol (LDL‐C) as the primary serum lipid target for recurrent stroke risk reduction. Nontraditional lipid variables including triglycerides/high‐density lipoprotein cholesterol (HDL‐C) ratio and total cholesterol/HDL‐C ratio are linked to a vascular risk as a residual risk factor. Since intracranial atherosclerotic stenosis (ICAS)‐related stroke is prevalent in Asian population, we evaluated the relationship between lipid indices and ICAS burden. Methods We analyzed consecutively enrolled 1220 patients with acute ischemic stroke from March 2009 to May February 2013, who underwent brain MRI and MRA. ICAS was defined as >/=50% stenosis and quantified by presence, >/=2, and >/=3. Study patients were divided into four groups according to level of nontraditional lipid variables: triglycerides/HDL‐C, total cholesterol/HDL‐C ratio, and low‐density lipoprotein cholesterol (LDL‐C)/HDL‐C ratio, and non‐HDL‐C. Independent associations of 4 lipid variables with ICAS were assessed. Results Table shows multivariable adjusted odds of ICAS by Increasing strata of each lipid indices. Compared with the lowest triglycerides/HDL‐C quartile, stepwise relationships were observed between increasing quartiles and the presence of ICAS (adjusted OR 1.04, 95% CI 0.68–1.58; 1.06, 0.69–1.62; and 1.80, 1.17–2.77), ICAS >/=2 (1.32, 0.83–2.09; 1.32, 0.82–2.11; and 1.72, 1.07–2.74), and ICAS >/=3 (2.49, 1.32–4.69; 2.98, 1.58–5.63; and 3.18, 1.67–6.04). Compared with the lowest total cholesterol/HDL‐C ratio, stepwise relationships were observed with ICAS >/=2 (1.51, 0.90–2.54; 1.56, 0.90–2.68; and 2.03, 1.00–3.74), and ICAS >/=3 (1.67, 0.84–3.33; 2.22, 1.10–4.51; and 2.63, 1.20–5.77). Relationships between LDL‐C/HDL‐C ratio and ICAS burden showed similar pattern to findings from total cholesterol/HDL‐C. Association between non‐HDL‐C and ICAS was not significant. Conclusion Among four lipid indices, elevated triglycerides/HDL‐C is more likely associated with ICAS burden. HDL‐C might exert as a crucial role for developing ICAS.