PT  - JOURNAL ARTICLE
AU  - Pan, Yuesong
AU  - Wangqin, Runqi
AU  - Li, Hao
AU  - Jin, Aoming
AU  - Li, Jiejie
AU  - Lin, Jinxi
AU  - Meng, Xia
AU  - Xian, Ying
AU  - Laskowitz, Daniel T
AU  - Wang, Yongjun
TI  - LDL-C levels, lipid-lowering treatment and recurrent stroke in minor ischaemic stroke or TIA
AID  - 10.1136/svn-2021-001317
DP  - 2022 Aug 01
TA  - Stroke and Vascular Neurology
PG  - 276--284
VI  - 7
IP  - 4
4099  - http://svn.bmj.com/content/7/4/276.short
4100  - http://svn.bmj.com/content/7/4/276.full
SO  - Stroke Vasc Neurol2022 Aug 01; 7
AB  - Background and purpose Dyslipidaemia is a major risk factor for ischaemic stroke and transient ischaemic attack (TIA). This study aimed to investigate the association between baseline low-density lipoprotein cholesterol (LDL-C) level, lipid-lowering treatment and short-term risk of new stroke in patients with a minor ischaemic stroke or TIA.Methods We derived data from the Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events trial. Patients with a minor stroke or TIA were categorised by LDL-C level at baseline (<2.6 or ≥2.6 mmol/L (100 mg/dL)) and with or without lipid-lowering treatment after symptom onset. The primary outcome was a new ischaemic stroke at 3 months. The association of baseline LDL-C level, lowering treatment and outcomes were assessed.Results Among 3027 patients, 2154 (71.2%) patients had an initial LDL-C ≥2.6 mmol/L, of which 1267 (41.9%) received lipid-lowering treatment. Elevated LDL-C level was associated with a higher risk of new ischaemic stroke at 3 months in patients without lipid-lowering treatment (adj.HR=1.35, 95% CI: 1.19 to 1.53), but not in those with lipid-lowering treatment (adj.HR=0.99, 95% CI: 0.82 to 1.19) (p for interaction=0.007). Patients with LDL-C ≥2.6 mmol/L had a numerically higher risk of ischaemic stroke (11.8% vs 8.0%, adj.HR=1.37, 95% CI: 0.96 to 1.96) in those without lipid-lowering treatment. For patients with LDL-C ≥2.6 mmol/L, lipid-lowering treatment was associated with reduced risk of ischaemic stroke at 3 months (7.9% vs 11.8%; adj.HR=0.54, 95% CI: 0.39 to 0.75).Conclusions Elevated untreated baseline LDL-C level was associated with an increased short-term risk of ischaemic stroke among patients presenting with minor ischaemic stroke or TIA. There was potential benefit of lipid-lowering treatment in minor stroke or TIA patients with LDL-C ≥2.6 mmol/L.Trial registration number NCT00979589.Data are available on reasonable request. Data are available to researchers on request for purposes of reproducing the results or replicating the procedure by directly contacting the corresponding author.