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Research Paper|Volume 11, Issue 5|pp 1589—1601

Low triglyceride to high-density lipoprotein cholesterol ratio predicts hemorrhagic transformation in large atherosclerotic infarction of acute ischemic stroke

Qi-Wen Deng1, Yu-Kai Liu1, Yu-Qiao Zhang1, Xiang-Liang Chen1, Teng Jiang1, Jian-Kang Hou1, Hong-Chao Shi1, Min Lu1, Feng Zhou1, Wei Wang1, Shuo Li2, Hui-Ling Sun3, Jun-Shan Zhou1
  • 1Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
  • 2Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing 210009, China
  • 3General Clinical Research Center, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

* * Equal contribution

Received: October 31, 2018Accepted: March 6, 2019Published: March 10, 2019
https://doi.org/10.18632/aging.101859

Copyright: © 2019 Deng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) is an objective approach to predicting poor outcomes in acute ischemic stroke (AIS). The impact of TG/HDL-C on hemorrhagic transformation (HT) after AIS remains unknown. The aim of this study was to explore the accurate effect of TG/HDL-C on HT after AIS. We enrolled a total of 1423 patients with AIS in the training cohort from a prospective, consecutive hospital-based stroke registry. Of the 1423 patients, HT occurred in 155 (10.89%) patients. The incidence of HT after AIS was significantly increased when there were low levels of TG (P=0.016) and TG/HDL-C (P=0.006) in patients with AIS attributable to large artery atherosclerosis (LAA), but not in those who suffered from cardioembolic stroke. After adjustment for covariates, a lower TG/HDL-C (OR=0.53, 95%CI=0.20-0.93) that was more than TG alone (OR=0.61, 95%CI=0.27-0.98) independently increased the risk of HT in LAA. Furthermore, our established nomogram indicated that lower TG/HDL-C was an indicator of HT. These findings were further validated in the test cohort of 558 patients with AIS attributable to LAA. In summary, a low level of TG/HDL-C is correlated with greater risk of HT after AIS attributable to LAA.