Oxidized Low-Density Lipoprotein to High-Density Lipoprotein Ratio Predicts Recurrent Stroke in Minor Stroke or Transient Ischemic Attack

Stroke. 2018 Nov;49(11):2637-2642. doi: 10.1161/STROKEAHA.118.022077.


Background and Purpose- Oxidized low-density lipoprotein (oxLDL) level is thought to be associated with recurrent stroke. We aimed to investigate the association between oxLDL to high-density lipoprotein (HDL) ratio and recurrent stroke in patients with minor stroke or transient ischemic attack. Methods- The study included 3019 patients with minor ischemic stroke or high-risk transient ischemic attack from the CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events). Baseline oxLDL and HDL levels were measured. The primary outcome was any stroke within 90 days. The secondary outcomes included any stroke within 1 year and ischemic stroke and combined vascular events within 90 days and 1 year. The association between oxLDL/HDL and recurrent stroke was analyzed by using Cox proportional hazards. Results- Patients in the highest oxLDL/HDL quartile had a higher risk of recurrent stroke within 90 days (hazards ratio, 1.50; 95% CI, 1.08-2.08) compared with the lowest quartile after adjusting relevant confounding factors ( P=0.02). Similar results were found for secondary outcomes ( P<0.05 for all). There were no significant interaction between oxLDL/HDL and use of statins agents. Conclusions- Higher serum oxLDL/HDL level in minor stroke or transient ischemic attack was associated with increased risk of recurrent stroke in 90 days and 1 year. OxLDL/HDL may act as a powerful indicator of recurrent stroke in patients with minor stroke or transient ischemic attack. Clinical Trial Registration- URL: http://www.clinicaltrials.gov . Unique identifier: NCT00979589.

Keywords: brain ischemia; humans; ischemic, transient, attack; oxidized low density lipoprotein; stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Brain Ischemia / blood
  • Brain Ischemia / epidemiology
  • China / epidemiology
  • Female
  • Humans
  • Ischemic Attack, Transient / blood
  • Ischemic Attack, Transient / epidemiology*
  • Lipoproteins, HDL / blood*
  • Lipoproteins, LDL / blood*
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Recurrence
  • Severity of Illness Index
  • Stroke / blood
  • Stroke / epidemiology*


  • Lipoproteins, HDL
  • Lipoproteins, LDL
  • oxidized low density lipoprotein

Associated data

  • ClinicalTrials.gov/NCT00979589