Repositorio
Institucional

O'Donnell, Martin J.

McQueen, Matthew

Sniderman, Allan

Pare, Guillaume

Wang, Xingyu

Hankey, Graeme J.

Rangarajan, Sumathy

Chin, Siu Lim

Rao-Melacini, Purnima

Ferguson, John

Xavier, Denis

Lisheng, Liu

Zhang, Hongye

Pais, Prem

Lopez-Jaramillo, Patricio

Damasceno, Albertino

Langhorne, Peter

Rosengren, Annika

Dans, Antonio L.

Elsayed, Ahmed

Avezum, Alvaro

Mondo, Charles

Judge, Conor

Diener, Hans-Christoph

Ryglewicz, Danuta

Czlonkowska, Anna

Pogosova, Nana

Weimar, Christian

Iqbal, Romana

Diaz, Rafael

Yusoff, Khalid

Yusufali, Afzalhussein

Oguz, Aytekin

Penaherrera, Ernesto

Lanas, Fernando

Ogah, Okechukwu S.

Ogunniyi, Adesola

Iversen, Helle K.

Malaga, German

Rumboldt, Zvonko

Oveisgharan, Shahram

Al Hussain, Fawaz

Nilanont, Yongchai

Yusuf, Salim

Association of Lipids, Lipoproteins, and Apolipoproteins with Stroke Subtypes in an International Case Control Study (INTERSTROKE)

KOREAN STROKE SOC

JOURNAL OF STROKE

en

Background and Purpose The association of dyslipidemia with stroke has been inconsistent, which may be due to differing associations within etiological stroke subtypes. We sought to determine the association of lipoproteins and apolipoproteins within stroke subtypes. Methods Standardized incident case-control STROKE study in 32 countries. Cases were patients with acute hospitalized first stroke, and matched by age, sex and site to controls. Concentrations of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (apoA1), and apoB were measured. Non-HDL-C was calculated. We estimated multivariable odds ratio (OR) and population attributable risk percentage (PAR%). Outcome measures were all stroke, ischemic stroke (and subtypes), and intracerebral hemorrhage (ICH). Results Our analysis included 11,898 matched case-control pairs, 77.3% with ischemic stroke and 22.7% with ICH. Increasing apoB (OR, 1.10, 95% confidence interval [CI], 1.06 to 1.14 per standard deviation [SD]) and LDL-C (OR, 1.06, 95% CI, 1.02 to 1.10 per SD) were associated with an increase in risk of ischemic stroke, but a reduced risk of ICH. Increased apoB was significantly associated with large vessel stroke (PAR 13.4%, 95% CI, 5.6 to 28.4) and stroke of undetermined cause. Higher HDL-C (OR, 0.75, 95% CI, 0.72 to 0.78 per SD) and apoA1 (OR, 0.63, 95% CI, 0.61 to 0.66 per SD) were associated with ischemic stroke (and subtypes). While increasing HDL-C was associated with an increased risk of ICH (OR, 1.20, 95% CI, 1.14 to 1.27 per SD), apoA1 was associated with a reduced risk (OR, 0.80, 95% CI, 0.75 to 0.85 per SD). ApoB/A1 (OR, 1.38, 95% CI, 1.32 to 1.44 per SD) had a stronger magnitude of association than the ratio of LDL-C/HDL-C (OR, 1.26, 95% CI, 1.21 to 1.31 per SD) with ischemic stroke (P<0.0001). Conclusions The pattern and magnitude of association of lipoproteins and apolipoproteins with stroke varies by etiological stroke subtype. While the directions of association for LDL, HDL, and apoB were opposing for ischemic stroke and ICH, apoA1 was associated with a reduction in both ischemic stroke and ICH. The ratio of apoB/A1 was the best lipid predictor of ischemic stroke risk.

artículo original

10.5853/jos.2021.02152

PDF

Stroke

Risk factor

Dyslipidemia

Lipoproteins

Apolipoproteins

Case-control

LOW-DENSITY-LIPOPROTEIN

CORONARY-HEART-DISEASE

OXFORDSHIRE COMMUNITY STROKE

ISCHEMIC-STROKE

MYOCARDIAL-INFARCTION

RISK-FACTORS

CARDIOVASCULAR RISK

HEMORRHAGIC STROKE

VASCULAR EVENTS

BLOOD-PRESSURE

Neurología Clínica

Enfermedad vascular periférica

Accidente cerebrovascular

Factor de riesgo

Dislipidemia

Lipoproteínas

Apolipoproteínas

Casos y controles

LIPOPROTEÍNAS DE BAJA DENSIDAD

ENFERMEDAD-CORONARIA DEL CORAZÓN

ACCULTO COMUNITARIO DE OXFORDSHIRE

ACCULTO ISQUÉMICO

INFARTO DE MIOCARDIO

FACTORES DE RIESGO

RIESGO CARDIOVASCULAR

ACCULO HEMORRÁGICO

VASCULAR EVENTOS

PRESION ARTERIAL

Medicina General e Interna

Sistema Cardiovascular y Cardiaco

Epidemiología

version publicada

diamante

acceso abierto

acceso abierto

WOS:000812327500005

Association of Lipids, Lipoproteins, and Apolipoproteins with Stroke Subtypes in an International Case Control Study (INTERSTROKE)

224

artículo original

CC BY-NC 4.0

CC BY-NC 4.0

PMC9194539