Oxidative lipoprotein markers predict poor functional outcome in patients with minor stroke or transient ischaemic attack.

Abstract

Oxidative stress plays an important role in acute ischaemic stroke. However, the association of oxidative lipoprotein markers, including oxidized low-density lipoprotein (oxLDL), oxLDL:high-density lipoprotein (HDL) and oxLDL:low-density lipoprotein (LDL), with functional outcome of minor stroke or transient ischaemic attack (TIA) remains unclear. We aimed to investigate the association between oxidative lipoprotein markers and poor functional outcome in patients with minor stroke or TIA. All patients with minor stroke or TIA were recruited from the Clopidogrel in High-Risk Patients With Acute Non-Disabling Cerebrovascular Events (CHANCE) trial. The poor functional outcome included modified Rankin Scale (mRS) score 2-6 and 3-6 at 90-day and 12-month follow-up. Multivariate logistic regression was used to investigate the associations of oxLDL, oxLDL:HDL and oxLDL:LDL with poor functional outcome. Among 3019 patients included in this study, the median (interquartile range) oxLDL, oxLDL:HDL and oxLDL:LDL were 13.96 (6.65-28.81), 4.52 (2.08-9.32) and 11.73 (5.27-24.85)μg/dL, respectively. After adjusted for confounding factors, patients in the highest oxLDL quartile had a higher proportion of mRS score 2-6 at 90days [hazard ratio (HR), 1.78; 95% confidence interval (CI), 1.26-2.52] and 12months (HR, 1.42; 95% CI, 1.01-1.99), and mRS score 3-6 at 90days (HR, 1.98; 95% CI, 1.29-3.04) and 12months (HR, 1.77; 95% CI, 1.09-2.89) when compared with the lowest oxLDL quartile (P<0.05). Similar results were found for oxLDL:HDL and oxLDL:LDL. Higher levels of oxidative lipoprotein markers are independent predictors of poor functional outcome in patients with minor stroke or TIA at 90days and 12months.