Low HDL-C level is associated with the development of intracranial artery stenosis: analysis from the Chinese IntraCranial AtheroSclerosis (CICAS) study

Document Type

Article

Abstract

BACKGROUND: Intracranial atherosclerotic stenosis (ICAS) is an important cause of ischemic stroke worldwide. The role of high-density lipoprotein cholesterol (HDL-C) or low-density lipoprotein cholesterol (LDL-C) in the development of ICAS remains to be elucidated. In the current study, we investigated the relationship of HDL-C level and the risk of developing ICAS in Chinese patients with acute ischemic stroke. METHODS: From October 2007 to June 2009, a total of 1,984 consecutive ischemic stroke patients were evaluated for the presence of symptomatic ICAS by magnetic resonance angiography (MRA). Patients were classified into two groups: intracranial steno-occlusion (ICAS group, n = 888) and non-intracranial stenosis (NICAS group, n = 1096). Serum lipid profiles were analyzed and compared between the ICAS and NICAS group. RESULTS: Significantly more patients in ICAS group had low HDL-C level (51.6%) than in the NICAS group (42.9%, P<0.001). The observed association remained significant after adjustment for conventional risk factors [(adjusted OR 1.36; 95%CI (1.13-1.63)]. Such predictive value of low level HDL-C persisted even when LDL-C was at very low level(<1.8 mmol/L). Patients in the lowest serum HDL-C quartile (<0.96 mmol/L) had the highest risk of developing ICAS [adjusted OR 1.52; 95%CI (1.17-1.98)] compared to patients in the highest serum HDL-C quartile (≥ 1.32 mmol/L) after adjustments for the covariates. CONCLUSIONS: Low HDL-C level is strongly associated with the development of ICAS. There was an inverse relationship between the level of HDL-C and the risk of developing ICAS.

Medical Subject Headings

China (epidemiology); Cholesterol, HDL (blood); Cohort Studies; Humans; Intracranial Arteriosclerosis (blood, epidemiology, pathology); Magnetic Resonance Angiography; Prospective Studies; Risk Factors; Statistics, Nonparametric; Stroke (blood, epidemiology, pathology)

Publication Date

1-1-2013

Publication Title

PloS one

E-ISSN

1932-6203

Volume

8

Issue

5

First Page

e64395

PubMed ID

23691210

Digital Object Identifier (DOI)

10.1371/journal.pone.0064395

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