Login Register Cart 0
Generic placeholder image

Current Pharmaceutical Design

Editor-in-Chief

ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Cumulative Exposure to Oxidized Low-density Lipoprotein is a Potential Predictor for Prognosis in Acute Ischemic Stroke: A Cohort Study

Author(s): Kaili Cheng, Xiuqi Chen, Yufan Luo, Wenbo Sun, Xiaoli Yang, Shengwen Huang, Yuanyuan Wang and Danhong Wu*

Volume 30, Issue 10, 2024

Published on: 27 February, 2024

Page: [778 - 785] Pages: 8

DOI: 10.2174/0113816128280291240220093912

Abstract

Background: Oxidized Low-Density Lipoprotein (ox-LDL) is crucial in the recrudescence and prognosis of acute ischemic stroke (AIS). We aimed to probe into the influence of cumulative ox-LDL exposure on the 90-day prognosis of AIS.

Methods: Patients with AIS were recruited in this research. AIS severity at admission was estimated with infarct volumes and National Institute of Health Stroke Scale (NIHSS) scores. AIS prognosis was assessed using Modified Rankin Scale (mRS) scores at 90 days and the change in NIHSS scores from admission to discharge. Cumulative ox-LDL exposure was defined as ox-LDL level (pg/mL) multiplied by age(y). Multivariate logistic regression analysis was employed to reveal the correlation between exposure factors and the prognosis of AIS. The prognostic prediction ability of cumulative ox-LDL exposure was compared with cumulative LDL exposure by the receiver operating characteristic curve (ROC).

Results: Higher cumulative ox-LDL exposure was related to worse prognosis, including neurological worsening at discharge (NIHSS increasing more than 2 points) (OR = 3.02, 95% CI, 1.30-6.98, P = 0.01) and poor functional prognosis at 90 days (mRS ≥ 3) (OR = 21.21, 95% CI, 4.72-95.36, P < 0.001). As multivariate regression analysis showed, significantly increased cumulative ox-LDL exposure was relevant to poor functional prognosis at 90 days (OR = 9.92, 95% CI, 1.23-79.76, P = 0.031), but not with neurological worsening at discharge (P = 0.414). ROC curve revealed that cumulative ox-LDL exposure had a higher predictive value (AUC = 0.843, P < 0.001) for functional prognosis of AIS than cumulative LDL exposure (AUC = 0.629, P = 0.023).

Conclusion: Cumulative ox-LDL exposure has a positive correlation with poor prognosis at 90 days of AIS, and has a more accurate predictive ability than cumulative LDL exposure.

Keywords: Cumulative exposure, acute ischemic stroke, oxidized low-density lipoprotein, low-density lipoprotein, prognosis, receiver operating characteristic curve.

« Previous Next »
[1]
Feigin VL, Stark BA, Johnson CO, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2021; 20(10): 795-820.
[http://dx.doi.org/10.1016/S1474-4422(21)00252-0] [PMID: 34487721]
[2]
Benjamin EJ, Virani SS, Callaway CW, et al. Heart disease and stroke statistics-2018 update: A report from the american heart association. Circulation 2018; 137(12): e67-e492.
[http://dx.doi.org/10.1161/CIR.0000000000000558] [PMID: 29386200]
[3]
Ma Q, Li R, Wang L, et al. Temporal trend and attributable risk factors of stroke burden in China, 1990–2019: An analysis for the global burden of disease study 2019. Lancet Public Health 2021; 6(12): e897-906.
[http://dx.doi.org/10.1016/S2468-2667(21)00228-0] [PMID: 34838196]
[4]
Vos T, Lim SS, Abbafati C, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: A systematic analysis for the global burden of disease study 2019. Lancet 2020; 396(10258): 1204-22.
[http://dx.doi.org/10.1016/S0140-6736(20)30925-9] [PMID: 33069326]
[5]
Bamford J, Sandercock P, Dennis M, Burn J, Warlow C. A prospective study of acute cerebrovascular disease in the community: The Oxfordshire Community Stroke Project-1981-86. 2. Incidence, case fatality rates and overall outcome at one year of cerebral infarction, primary intracerebral and subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 1990; 53(1): 16-22.
[http://dx.doi.org/10.1136/jnnp.53.1.16] [PMID: 2303826]
[6]
Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002; 105(9): 1135-43.
[http://dx.doi.org/10.1161/hc0902.104353] [PMID: 11877368]
[7]
Winterbourn CC. Reconciling the chemistry and biology of reactive oxygen species. Nat Chem Biol 2008; 4(5): 278-86.
[http://dx.doi.org/10.1038/nchembio.85] [PMID: 18421291]
[8]
Poznyak AV, Nikiforov NG, Markin AM, et al. Overview of OxLDL and its impact on cardiovascular health: Focus on atherosclerosis. Front Pharmacol 2021; 11: 613780.
[http://dx.doi.org/10.3389/fphar.2020.613780] [PMID: 33510639]
[9]
Jiang H, Zhou Y, Nabavi SM, et al. Mechanisms of oxidized LDL-mediated endothelial dysfunction and its consequences for the development of atherosclerosis. Front Cardiovasc Med 2022; 9: 925923.
[http://dx.doi.org/10.3389/fcvm.2022.925923] [PMID: 35722128]
[10]
Wang A, Xu J, Chen G, et al. Oxidized low-density lipoprotein predicts recurrent stroke in patients with minor stroke or TIA. Neurology 2018; 91(10): e947-55.
[http://dx.doi.org/10.1212/WNL.0000000000006118] [PMID: 30089614]
[11]
Wang A, Cui Y, Meng X, et al. The relationship between oxidized low-density lipoprotein and the NIHSS score among patients with acute ischemic stroke: The SOS-stroke study. Atherosclerosis 2018; 270: 21-5.
[http://dx.doi.org/10.1016/j.atherosclerosis.2018.01.028] [PMID: 29407884]
[12]
Wang A, Yang Y, Su Z, et al. Association of oxidized low-density lipoprotein with prognosis of stroke and stroke subtypes. Stroke 2017; 48(1): 91-7.
[http://dx.doi.org/10.1161/STROKEAHA.116.014816] [PMID: 27899755]
[13]
Yang X, Sun W, Hou D, et al. The degree of plasma oxidized low-density lipoprotein level decrease is related to clinical outcomes for patients with acute ischemic stroke. Dis Markers 2021; 2021: 1-7.
[http://dx.doi.org/10.1155/2021/4998823] [PMID: 34950249]
[14]
Ference BA, Graham I, Tokgozoglu L, Catapano AL. Impact of lipids on cardiovascular health. J Am Coll Cardiol 2018; 72(10): 1141-56.
[http://dx.doi.org/10.1016/j.jacc.2018.06.046] [PMID: 30165986]
[15]
Brott T, Adams HP Jr, Olinger CP, et al. Measurements of acute cerebral infarction: A clinical examination scale. Stroke 1989; 20(7): 864-70.
[http://dx.doi.org/10.1161/01.STR.20.7.864] [PMID: 2749846]
[16]
Mattern L, Chen C, McClure LA, et al. Serum zinc levels and incidence of ischemic stroke: The reasons for geographic and racial differences in stroke study. Stroke 2021; 52(12): 3953-60.
[http://dx.doi.org/10.1161/STROKEAHA.120.033187] [PMID: 34412513]
[17]
Yushkevich PA, Piven J, Hazlett HC, et al. User-guided 3D active contour segmentation of anatomical structures: Significantly improved efficiency and reliability. Neuroimage 2006; 31(3): 1116-28.
[http://dx.doi.org/10.1016/j.neuroimage.2006.01.015] [PMID: 16545965]
[18]
Haley EC Jr, Brott TG, Sheppard GL, et al. Pilot randomized trial of tissue plasminogen activator in acute ischemic stroke. Stroke 1993; 24(7): 1000-4.
[http://dx.doi.org/10.1161/01.STR.24.7.1000] [PMID: 8322373]
[19]
Toyoda K, Fujimoto S, Kamouchi M, Iida M, Okada Y. Acute blood pressure levels and neurological deterioration in different subtypes of ischemic stroke. Stroke 2009; 40(7): 2585-8.
[http://dx.doi.org/10.1161/STROKEAHA.108.543587] [PMID: 19407233]
[20]
Kumar S, Sahana D, Rathore L, et al. Extra-axial endoscopic third ventriculostomy: Preliminary experience with a technique to circumvent conventional endoscopic third ventriculostomy complications. J Neurosurg 2023; 138(2): 503-13.
[http://dx.doi.org/10.3171/2022.5.JNS22589] [PMID: 35901703]
[21]
Libby P. Current concepts of the pathogenesis of the acute coronary syndromes. Circulation 2001; 104(3): 365-72.
[http://dx.doi.org/10.1161/01.CIR.104.3.365] [PMID: 11457759]
[22]
Xu S, Ilyas I, Little PJ, et al. Endothelial dysfunction in atherosclerotic cardiovascular diseases and beyond: From mechanism to pharmacotherapies. Pharmacol Rev 2021; 73(3): 924-67.
[http://dx.doi.org/10.1124/pharmrev.120.000096] [PMID: 34088867]
[23]
Vink H, Constantinescu AA, Spaan JAE. Oxidized lipoproteins degrade the endothelial surface layer: Implications for platelet-endothelial cell adhesion. Circulation 2000; 101(13): 1500-2.
[http://dx.doi.org/10.1161/01.CIR.101.13.1500] [PMID: 10747340]
[24]
Fujimura N, Jitsuiki D, Maruhashi T, et al. Geranylgeranylacetone, heat shock protein 90/AMP-activated protein kinase/endothelial nitric oxide synthase/nitric oxide pathway, and endothelial function in humans. Arterioscler Thromb Vasc Biol 2012; 32(1): 153-60.
[http://dx.doi.org/10.1161/ATVBAHA.111.237263] [PMID: 21998134]
[25]
Ning DS, Ma J, Peng YM, et al. Apolipoprotein A-I mimetic peptide inhibits atherosclerosis by increasing tetrahydrobiopterin via regulation of GTP-cyclohydrolase 1 and reducing uncoupled endothelial nitric oxide synthase activity. Atherosclerosis 2021; 328: 83-91.
[http://dx.doi.org/10.1016/j.atherosclerosis.2021.05.019] [PMID: 34118596]
[26]
Obermayer G, Afonyushkin T, Binder CJ. Oxidized low-density lipoprotein in inflammation-driven thrombosis. J Thromb Haemost 2018; 16(3): 418-28.
[http://dx.doi.org/10.1111/jth.13925] [PMID: 29316215]
[27]
Kita T, Kume N, Minami M, et al. Role of oxidized LDL in atherosclerosis. Ann N Y Acad Sci 2001; 947(1): 199-206.
[http://dx.doi.org/10.1111/j.1749-6632.2001.tb03941.x] [PMID: 11795267]
[28]
Kakutani M, Masaki T, Sawamura T. A platelet–endothelium interaction mediated by lectin-like oxidized low-density lipoprotein receptor-1. Proc Natl Acad Sci USA 2000; 97(1): 360-4.
[http://dx.doi.org/10.1073/pnas.97.1.360] [PMID: 10618423]
[29]
Hu C, Dandapat A, Sun L, et al. Modulation of angiotensin II-mediated hypertension and cardiac remodeling by lectin-like oxidized low-density lipoprotein receptor-1 deletion. Hypertension 2008; 52(3): 556-62.
[http://dx.doi.org/10.1161/HYPERTENSIONAHA.108.115287] [PMID: 18645046]
[30]
Frostegård J, Wu R, Lemne C, Thulin T, Witztum JL, De Faire U. Circulating oxidized low-density lipoprotein is increased in hypertension. Clin Sci 2003; 105(5): 615-20.
[http://dx.doi.org/10.1042/CS20030152] [PMID: 12837127]
[31]
Dotevall A, Hulthe J, Rosengren A, Wiklund O, Wilhelmsen L. Autoantibodies against oxidized low-density lipoprotein and C-reactive protein are associated with diabetes and myocardial infarction in women. Clin Sci 2001; 101(5): 523-31.
[http://dx.doi.org/10.1042/cs1010523] [PMID: 11672458]
[32]
Lautamäki R, Rönnemaa T, Huupponen R, et al. Low serum adiponectin is associated with high circulating oxidized low-density lipoprotein in patients with type 2 diabetes mellitus and coronary artery disease. Metabolism 2007; 56(7): 881-6.
[http://dx.doi.org/10.1016/j.metabol.2007.01.018] [PMID: 17570246]
[33]
Bak S, Gaist D, Sindrup SH, Skytthe A, Christensen K. Genetic liability in stroke: A long-term follow-up study of Danish twins. Stroke 2002; 33(3): 769-74.
[http://dx.doi.org/10.1161/hs0302.103619] [PMID: 11872902]

Rights & Permissions Print Cite
Article Metrics
15
2
© 2024 Bentham Science Publishers | Privacy Policy