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Triglyceride to high‐density lipoprotein cholesterol ratio predicts worse outcomes after acute ischaemic stroke
Author(s) -
Deng Q.W.,
Wang H.,
Sun C.Z.,
Xing F.L.,
Zhang H.Q.,
Zuo L.,
Gu Z.T.,
Yan F.L.
Publication year - 2017
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13198
Subject(s) - medicine , triglyceride , receiver operating characteristic , odds ratio , cholesterol , modified rankin scale , high density lipoprotein , gastroenterology , area under the curve , stroke (engine) , ischemic stroke , ischemia , engineering , mechanical engineering
Background and purpose The effect of the triglyceride ( TG ) to high‐density lipoprotein cholesterol ( HDL ‐C) ratio ( TG / HDL ‐C) on clinical outcomes of acute ischaemic stroke ( AIS ) patients is unclear. This study sought to determine whether the TG / HDL ‐C ratio in AIS patients is associated with worse outcomes at 3 months. Methods Acute ischaemic stroke patients who were admitted from 2011 to 2014 were enrolled in this study. TG , total cholesterol ( TC ), HDL ‐C and low‐density lipoprotein cholesterol ( LDL ‐C) were collected on admission. Three end‐points were defined according to the modified Rankin scale ( mRS ) score at 3 months after symptom onset (excellent outcome, mRS 0–1; good outcome, mRS 0–2; and death, mRS 6). Results In all, 1006 patients were included (median age 68.5 years; 58.2% male). Higher TG , non‐ HDL ‐C and TG / HDL ‐C were strongly associated with the three end‐points after adjustments: excellent [odds ratio ( OR ) = 1.39, OR 1.89 and OR 2.34, respectively] and good ( OR 1.48, OR 2.90 and OR 4.12) outcomes, and death ( OR 0.59, OR 0.29 and OR 0.26). According to receiver operating characteristic ( ROC ) analysis, the best discriminating factor was a TG / HDL ‐C ≥ 0.87 for excellent outcomes [area under the ROC curve ( AUC ) 0.596; sensitivity 73.3%; specificity 42.7%] and non‐death ( AUC 0.674; sensitivity 67.8%; specificity 60.6%) as well as a TG / HDL ‐C ≥ 1.01 for a good outcome ( AUC 0.652; sensitivity 61.6%; specificity 63.2%). Patients with a TG / HDL ‐C < 0.87 had a 2.94‐fold increased risk of death (95% confidence interval 1.89–4.55) compared with patients with a TG / HDL ‐C ≥ 0.87. Conclusions A lower TG / HDL ‐C was independently associated with death and worse outcome at 3 months in AIS .