LDL-C/HDL-C Is Associated With Ischaemic Stroke In Patients With Valvular Atrial Fibrillation:A Case-control Study

Objective: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.Logistic regression analysis,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）;Obesity and smoking significantly increased the risk of IS,the former was 2.27-fold higher than in normal-weight subjects,the latter was 3.15-fold higher than non-smoking patients.The C statistic of LDL-C/HDL-C was 0.76,the optimal critical value was 2.33,with high sensitivity and specificity.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.Conclusion:LDL-C/HDL-C>1.22,smoking,BMI≥24 kg/m²and CHA₂DS₂-VASc score were independent risk factors for IS in NVAF patients.LDL-C/HDL-C is the main risk factor,which manifests that LDL-C/HDL-C may help identify AF individuals who are at high risk of IS and who may benefit from lipid-lowering therapy.