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LDL-C/HDL-C is associated with ischaemic stroke in patients with non-valvular atrial fibrillation: a case-control study
Xian-Hui Zhou
Xinjiang Medical University Affiliated First Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2209-1367
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Lipids in Health and Disease.
Background: This study explored the relationships between the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and other clinical indicators and ischaemic stroke (IS) in patients with non-valvular atrial fibrillation (NVAF) in Xinjiang. The findings could provide a theoretical and therapeutic basis for NVAF patients.
Methods: NVAF patients who were admitted to 10 medical centres across Xinjiang were divided into stroke (798 patients) and control (2671 patients) groups according to the occurrence of first acute IS. Univariate and multivariate logistic regression analysis were used to examine the independent risk factors for IS in NVAF patients. Factor analysis and principal component regression analysis were used to analyse the main factors influencing IS. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminatory ability of LDL-C/HDL-C for predicting the occurrence of IS.
Results: The stroke group had an average age of 71.64 ± 9.96 years and included 305 females (38.22%). The control group had a mean age of 67.30 ± 12.01 years and included 825 females (30.89%). Multivariate logistic regression showed that the risk of IS in the highest LDL-C/HDL-C quartile ( ≥2.73) was 16.23-fold that of the lowest quartile ( < 1.22); IS risk was 2.27-fold higher in obese patients than in normal-weight subjects; IS risk was 3.15-fold higher in smoking patients than in non-smoking patients. The area under the ROC curve of LDL-C/HDL-C was 0.76, the optimal critical value was 2.33, the sensitivity was 63.53%, and the specificity was 76.34%. Principal component regression analysis showed that LDL-C/HDL-C, age, smoking, drinking, LDL-C and hypertension were risk factors for IS in NVAF patients.
Conclusions: LDL-C/HDL-C >1.22, smoking, BMI ≥24 kg/m2 and CHA2DS2-VASc score were independent risk factors for IS in NVAF patients; LDL-C/HDL-C was the main risk factor.
Keywords
non-valvular atrial fibrillation, ischaemic stroke, low-/high-density lipoprotein cholesterol ratio, case-control study, principal component regression analysis, lipoproteins, Xinjiang
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On 07 Oct, 2020
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Editorial decision: Accept
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Invitations sent on 18 Sep, 2020
Reviewer #1 agreed
On 18 Sep, 2020
Reviewer #2 agreed
On 18 Sep, 2020
Reviewer #3 agreed
On 18 Sep, 2020
Reviewer #4 agreed
On 18 Sep, 2020
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Received 18 Sep, 2020
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Received 18 Sep, 2020
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Received 18 Sep, 2020
Editor assigned
On 17 Sep, 2020
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Received 04 Sep, 2020
Editorial decision: Major revision
On 04 Sep, 2020
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Received 29 Aug, 2020
Review #1 received
Received 28 Aug, 2020
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Received 27 Aug, 2020
Reviewer #5 agreed
On 26 Aug, 2020
Reviewer #1 agreed
On 23 Aug, 2020
Reviewer #2 agreed
On 23 Aug, 2020
Reviewer #3 agreed
On 23 Aug, 2020
Reviewer #4 agreed
On 23 Aug, 2020
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This preprint is under consideration at Lipids in Health and Disease. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
LDL-C/HDL-C is associated with ischaemic stroke in patients with non-valvular atrial fibrillation: a case-control study
Xian-Hui Zhou
Xinjiang Medical University Affiliated First Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2209-1367
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 25 Sep, 2020
Published
On 07 Oct, 2020
No community comments so far
Reviewer #1 agreed
On 24 Sep, 2020
Review #1 received
Received 24 Sep, 2020
Editorial decision: Accept
On 24 Sep, 2020
Editor assigned
On 23 Sep, 2020
Reviewers invited
Invitations sent on 23 Sep, 2020
Submission checks complete
On 22 Sep, 2020
Editor invited
On 22 Sep, 2020
No comments provided
Reviewers invited
Invitations sent on 18 Sep, 2020
Reviewer #1 agreed
On 18 Sep, 2020
Reviewer #2 agreed
On 18 Sep, 2020
Reviewer #3 agreed
On 18 Sep, 2020
Reviewer #4 agreed
On 18 Sep, 2020
Review #2 received
Received 18 Sep, 2020
Review #3 received
Received 18 Sep, 2020
Review #1 received
Received 18 Sep, 2020
Editor assigned
On 17 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Editor invited
On 16 Sep, 2020
No comments provided
Review #4 received
Received 04 Sep, 2020
Editorial decision: Major revision
On 04 Sep, 2020
Review #3 received
Received 29 Aug, 2020
Review #1 received
Received 28 Aug, 2020
Review #2 received
Received 27 Aug, 2020
Reviewer #5 agreed
On 26 Aug, 2020
Reviewer #1 agreed
On 23 Aug, 2020
Reviewer #2 agreed
On 23 Aug, 2020
Reviewer #3 agreed
On 23 Aug, 2020
Reviewer #4 agreed
On 23 Aug, 2020
Reviewers invited
Invitations sent on 20 Aug, 2020
Editor assigned
On 17 Aug, 2020
First submitted
On 16 Aug, 2020
Submission checks complete
On 16 Aug, 2020
Editor invited
On 16 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Lipids in Health and Disease.
Background: This study explored the relationships between the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and other clinical indicators and ischaemic stroke (IS) in patients with non-valvular atrial fibrillation (NVAF) in Xinjiang. The findings could provide a theoretical and therapeutic basis for NVAF patients.
Methods: NVAF patients who were admitted to 10 medical centres across Xinjiang were divided into stroke (798 patients) and control (2671 patients) groups according to the occurrence of first acute IS. Univariate and multivariate logistic regression analysis were used to examine the independent risk factors for IS in NVAF patients. Factor analysis and principal component regression analysis were used to analyse the main factors influencing IS. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminatory ability of LDL-C/HDL-C for predicting the occurrence of IS.
Results: The stroke group had an average age of 71.64 ± 9.96 years and included 305 females (38.22%). The control group had a mean age of 67.30 ± 12.01 years and included 825 females (30.89%). Multivariate logistic regression showed that the risk of IS in the highest LDL-C/HDL-C quartile ( ≥2.73) was 16.23-fold that of the lowest quartile ( < 1.22); IS risk was 2.27-fold higher in obese patients than in normal-weight subjects; IS risk was 3.15-fold higher in smoking patients than in non-smoking patients. The area under the ROC curve of LDL-C/HDL-C was 0.76, the optimal critical value was 2.33, the sensitivity was 63.53%, and the specificity was 76.34%. Principal component regression analysis showed that LDL-C/HDL-C, age, smoking, drinking, LDL-C and hypertension were risk factors for IS in NVAF patients.
Conclusions: LDL-C/HDL-C >1.22, smoking, BMI ≥24 kg/m2 and CHA2DS2-VASc score were independent risk factors for IS in NVAF patients; LDL-C/HDL-C was the main risk factor.
Figure 1
Figure 2