title: Relation of Low-Density Lipoprotein Cholesterol to Ischemic Stroke in Patients With Nonvalvular Atrial Fibrillation.
abstract: Low-density lipoprotein cholesterol (LDL-C) has been demonstrated as an independent risk factor of ischemic stroke, but the association of LDL-C with ischemic stroke in patients with nonvalvular atrial fibrillation (AF) remains uncertain. Our objective was to explore whether LDL-C could refine stroke stratification in patients with AF. A total of 424 nonvalvular patients with AF with ischemic stroke and 391 ones without ischemic stroke were enrolled. No patient had received antithrombotic therapy. Multivariate logistic regression analysis showed that LDL-C was an independent predictor of ischemic stroke in patients with AF, with the adjusted odds ratio of 2.004 (95% confidence interval 1.624 to 2.473; p <0.001). The receiver operating characteristic analysis revealed that the best cut-off value of LDL-C to predict ischemic stroke in patients with AF was 2.48 mmol/L with 56.3% sensitivity and 66.3% specificity (area under the curve: 0.651, p <0.001). In the subgroup analysis based on different CHA2DS2-VASc scores, the predictive value of LDL-C remained significant in patients with a CHA2DS2-VASc score of ≤5. In conclusion, LDL-C was an independent predictor of ischemic stroke, which could potentially refine stroke stratification in patients with AF. A prospective study with a large number of patients is required to validate the current findings.
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Qi
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Zhichao
authors.initials: Z
authors.lastname: Wen
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Yuan
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Huanchun
authors.initials: H
authors.lastname: Ni
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Gao
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Yangyi
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Shan
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Jin
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Pingping
authors.initials: P
authors.lastname: Yan
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Haiming
authors.initials: H
authors.lastname: Shi
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China. Electronic address: luoxp2007@aliyun.com.
authors.forename: Xinping
authors.initials: X
authors.lastname: Luo
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood*; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020521:Stroke / Q000097:blood*
chemical_list: D008078:Cholesterol, LDL; D002784:Cholesterol