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Aging and Disease    2018, Vol. 9 Issue (3) : 498-506     DOI: 10.14336/AD.2017.0629
Orginal Article |
The Short-term Prognostic Value of the Triglyceride-to-high-density Lipoprotein Cholesterol Ratio in Acute Ischemic Stroke
Qi-Wen Deng,Shuo Li,Huan Wang,Leix Lei,Han-Qing Zhang,Zheng-Tian Gu,Fang-Lan Xing,Fu-Ling Yan
Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
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Abstract  

The triglyceride (TG)-to-high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C) is a simple approach to predicting unfavorable outcomes in cardiovascular disease. The influence of TG/HDL-C on acute ischemic stroke remains elusive. The purpose of this study was to investigate the precise effect of TG/HDL-C on 3-month mortality after acute ischemic stroke (AIS). Patients with AIS were enrolled in the present study from 2011 to 2017. A total of 1459 participants from a single city in China were divided into retrospective training and prospective test cohorts. Medical records were collected periodically to determine the incidence of fatal events. All participants were followed for 3 months. Optimal cutoff values were determined using X-tile software to separate the training cohort patients into higher and lower survival groups based on their lipid levels. A survival analysis was conducted using Kaplan-Meier curves and a Cox proportional hazards regression model. A total of 1459 patients with AIS (median age 68.5 years, 58.5% male) were analyzed. Univariate Cox regression analysis confirmed that TG/HDL-C was a significant prognostic factor for 3-month survival. X-tile identified 0.9 as an optimal cutoff for TG/HDL-C. In the univariate analysis, the prognosis of the TG/HDL-C >0.9 group was markedly superior to that of TG/HDL-C ≤0.9 group (P<0.001). A multivariate Cox regression analysis showed that TG/HDL-C was independently correlated with a reduced risk of mortality (hazard ratio [HR], 0.39; 95% confidence interval [CI], 0.24-0.62; P<0.001). These results were confirmed in the 453 patients in the test cohort. A nomogram was constructed to predict 3-month case-fatality, and the c-indexes of predictive accuracy were 0.684 and 0.670 in the training and test cohorts, respectively (P<0.01). The serum TG/HDL-C ratio may be useful for predicting short-term mortality after AIS.

Keywords triglyceride      high-density lipoprotein cholesterol      TG/HDL-C      acute ischemic stroke      survival     
Corresponding Authors: Fu-Ling Yan   
Issue Date: 05 June 2018
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Qi-Wen Deng
Shuo Li
Huan Wang
Leix Lei
Han-Qing Zhang
Zheng-Tian Gu
Fang-Lan Xing
Fu-Ling Yan
Cite this article:   
Qi-Wen Deng,Shuo Li,Huan Wang, et al. The Short-term Prognostic Value of the Triglyceride-to-high-density Lipoprotein Cholesterol Ratio in Acute Ischemic Stroke[J]. A&D, 2018, 9(3): 498-506.
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http://www.aginganddisease.org/EN/10.14336/AD.2017.0629     OR     http://www.aginganddisease.org/EN/Y2018/V9/I3/498
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