• Anxin Wang, Shiyu Li, Nan Zhang, Liye Dai, Yingting Zuo, Yilong Wang, Xia Meng, and Yongjun Wang.
• From the Department of Neurology (A.W., S.L., N.Z., L.D., Y.Z., Y.W., X.M., Y.W.), Beijing Tiantan Hospital, Capital Medical University, China.
• Stroke. 2018 Nov 1; 49 (11): 2637-2642.

AbstractBackground and Purpose- Oxidized low-density lipoprotein (oxLDL) level is thought to be associated with recurrent stroke. We aimed to investigate the association between oxLDL to high-density lipoprotein (HDL) ratio and recurrent stroke in patients with minor stroke or transient ischemic attack. Methods- The study included 3019 patients with minor ischemic stroke or high-risk transient ischemic attack from the CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events). Baseline oxLDL and HDL levels were measured. The primary outcome was any stroke within 90 days. The secondary outcomes included any stroke within 1 year and ischemic stroke and combined vascular events within 90 days and 1 year. The association between oxLDL/HDL and recurrent stroke was analyzed by using Cox proportional hazards. Results- Patients in the highest oxLDL/HDL quartile had a higher risk of recurrent stroke within 90 days (hazards ratio, 1.50; 95% CI, 1.08-2.08) compared with the lowest quartile after adjusting relevant confounding factors ( P=0.02). Similar results were found for secondary outcomes ( P<0.05 for all). There were no significant interaction between oxLDL/HDL and use of statins agents. Conclusions- Higher serum oxLDL/HDL level in minor stroke or transient ischemic attack was associated with increased risk of recurrent stroke in 90 days and 1 year. OxLDL/HDL may act as a powerful indicator of recurrent stroke in patients with minor stroke or transient ischemic attack. Clinical Trial Registration- URL: http://www.clinicaltrials.gov . Unique identifier: NCT00979589.

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