Title:Relationship of the Low-Density Lipoprotein Cholesterol/High-Density
Lipoprotein Cholesterol Ratio with a Vulnerable Plaque in Patients with
Severe Carotid Artery Stenosis: A Case-Control Study in the Han Chinese
Population
Volume: 19
Issue: 2
Author(s): Heqian Liu, Zhipeng Chen, Jiawen Ding, Subinuer Mamateli, Jing Cai and Tong Qiao*
Affiliation:
- Department of vascular Surgery, Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical University, Nanjing,
210008, China
Keywords:
Severe carotid artery stenosis, LDL-c/HDL-c, vulnerable plaque, case-control study, logistic regression analysis, carotid angiography.
Abstract:
Background: Carotid plaque is often an important factor in ischemic stroke after it
changes from stable to vulnerable, and low-density lipoprotein cholesterol (LDL-c) and high-density
lipoprotein cholesterol (HDL-c) are associated with plaque vulnerability. We aimed to investigate
whether the LDL-c/HDL-c ratio, an easily available and novel biomarker, is associated with vulnerable
plaques and enhances the warning effect on vulnerability compared to LDL-c or HDL-c alone.
Methods: We conducted a retrospective study of 187 patients with severe CAS admitted to the Department
of Vascular Surgery at the Nanjing Drum Tower Hospital from January 2019 to July 2021.
They were divided into a stable plaque group and a vulnerable plaque group according to carotid
ultrasonography, carotid angiography (CTA), and plaque pathology. Baseline information was collected
and compared between the two groups. Correlation analysis was used to determine the degree
of correlation between clinical variables. Univariate and multifactor logistic regression analyses
were used to examine independent risk factors for vulnerable plaque in patients with severe CAS.
Receiver operating characteristic (ROC) curves were used to assess the capacity of LDL-c/HDL-c to
predict the occurrence of vulnerable plaque.
Results: The age of the vulnerable plaque group was 68.12 ± 8.90 years, with 85 males (89.91%);
the age of the stable plaque group was 68.77 ± 8.43 years, with 70 males (89.74%). Multivariate
logistic regression analysis showed that LDL-c/HDL-c, smoking and diabetes were independent risk
factors for vulnerable plaque (all P <0.05). The risk of vulnerable plaque was 4.78-fold greater in
the highest LDL-c/HDL-c quartile (≥ 2.63) than in the lowest quartile (≤ 1.31) (P-trend <0.001), and
the area under the ROC curve for LDL-c/HDL-c (AUC=0.681, P <0.001) was higher than that for
LDL-c and HDL-c.
Conclusion: LDL-c/HDL-c, smoking and diabetes were independent risk factors for vulnerable
plaque in patients with severe CAS, and LDL-c/HDL-c had a higher predictive value for the presence
of vulnerable plaque compared with other lipid parameters.
