What is the clinical evidence from this study?

Study design: Observational. Population: Carotid atherosclerosis (n=94). Intervention: Lipoprotein quality parameters (HDL and LDL). Primary outcome: Mortality and major adverse cardiovascular events (stroke, myocardial infarction, and vascular death) (aHR 2.13, p=<0.001).

What question did this study set out to answer?

This study aims to evaluate the prognostic significance of HDL and LDL quality parameters in patients with carotid atherosclerosis, specifically regarding mortality and major adverse cardiovascular events (MACE).

May 8, 2026European Stroke JournalOpen Access

Abstract Number: Esoc2026a1727 Low HDL Cholesterol Levels and Altered LDL Modification-Related Parameters Predict Adverse Outcomes in Patients With Carotid Atherosclerosis

Q: What are the key findings of this study?

Triglyceride-enriched HDL was associated with increased MACE (aHR 2.13, p<0.001), and reduced LDL resistance to oxidation predicted higher mortality (aHR 0.71, p=0.024) in carotid stenosis.

Q: What question did this study set out to answer?

This study aims to evaluate the prognostic significance of HDL and LDL quality parameters in patients with carotid atherosclerosis, specifically regarding mortality and major adverse cardiovascular events (MACE).

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Key result

Triglyceride-enriched HDL is linked to ~113% higher MACE risk in carotid stenosis.

aHR 2.13
P<0.001
n=94

Why the study?

Lipoprotein composition and function are altered in ischaemic stroke with carotid atherosclerosis, but the prognostic value of HDL and LDL quality parameters for mortality and MACE remained to be evaluated.

Do HDL and LDL quality parameters predict mortality and MACE in patients with carotid atherosclerosis?

Population

62 symptomatic and 32 asymptomatic patients with ≥50% internal carotid artery stenosis undergoing carotid endarterectomy

Comparison

HDL and LDL quality parameters and lipid profile

Design

Prospective observational study

Follow-up

1 year

Authors

NPNúria PuigHospital de Sant Pau AAAna Aguilera‐SimónHospital de Sant Pau MMMontserrat Moncunill-CopovíUniversitat Autònoma de Barcelona

Discussion

Member takes

Overview

May enhance risk stratification beyond stenosis in carotid patients; leaves open if targeting LDL oxidative resistance reduces mortality and MACE.

Key Points

This study aims to evaluate the prognostic significance of HDL and LDL quality parameters in patients with carotid atherosclerosis, specifically regarding mortality and major adverse cardiovascular events (MACE).
Prospective observational study of patients with ≥50% internal carotid artery stenosis undergoing carotid endarterectomy from 2020 to 2023.
Cohort included 62 symptomatic and 32 asymptomatic patients, followed for 1 year.
Cox regression analyses assessed associations with mortality and MACE.
Higher LDL susceptibility to oxidation associated with increased mortality (aHRx1 min-increase=0.71, p=0.024).
Lower HDL cholesterol linked inversely with MACE (HRx1 mmol/L-increase=0.02, p=0.024).
Increased triglyceride content in HDL positively associated with MACE (aHRx1 %-increase=2.13, p<0.001).

Study Design

Type

Observational (n=94)

Structured PICO

Do HDL and LDL quality parameters predict mortality and MACE in patients with carotid atherosclerosis?

Population

94 patients with ≥50% internal carotid artery stenosis undergoing carotid endarterectomy from 2020 to 2023 (62 symptomatic with recent stroke, 32 asymptomatic with no stroke within 6 months).

Intervention

HDL and LDL quality parameters (lipoprotein composition, LDL resistance to oxidation, aggregated LDL)

Outcome

Mortality and three-point MACE (stroke, myocardial infarction, and vascular death)composite

Main Result

Effect estimate: aHR 2.13

p-value: p=<0.001

In patients with significant carotid stenosis, lipoprotein quality parameters such as LDL susceptibility to oxidation/aggregation and HDL triglyceride content predict mortality and MACE beyond standard lipid profiles.

Cite This Study

Puig et al. (2026) conducted an observational in Carotid atherosclerosis (n=94). Lipoprotein quality parameters (HDL and LDL) was evaluated on Mortality and major adverse cardiovascular events (stroke, myocardial infarction, and vascular death) (aHR 2.13, p=<0.001). Triglyceride-enriched HDL was associated with increased MACE (aHR 2.13, p<0.001), and reduced LDL resistance to oxidation predicted higher mortality (aHR 0.71, p=0.024) in carotid stenosis.

synapsesocial.com/papers/69fd7f4fbfa21ec5bbf07d98 https://doi.org/10.1093/esj/aakag023.814

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May 8, 2026European Stroke JournalOpen Access

Abstract Number: Esoc2026a1727 Low HDL Cholesterol Levels and Altered LDL Modification-Related Parameters Predict Adverse Outcomes in Patients With Carotid Atherosclerosis

View Full Paper

Ask AI

Bookmark

Key result

Triglyceride-enriched HDL is linked to ~113% higher MACE risk in carotid stenosis.

aHR 2.13
P<0.001
n=94

Why the study?

Do HDL and LDL quality parameters predict mortality and MACE in patients with carotid atherosclerosis?

Population

62 symptomatic and 32 asymptomatic patients with ≥50% internal carotid artery stenosis undergoing carotid endarterectomy

Comparison

HDL and LDL quality parameters and lipid profile

Design

Prospective observational study

Follow-up

1 year

Authors

NPNúria PuigHospital de Sant Pau AAAna Aguilera‐SimónHospital de Sant Pau MMMontserrat Moncunill-CopovíUniversitat Autònoma de Barcelona

Discussion

Member takes

Overview

May enhance risk stratification beyond stenosis in carotid patients; leaves open if targeting LDL oxidative resistance reduces mortality and MACE.

Key Points

This study aims to evaluate the prognostic significance of HDL and LDL quality parameters in patients with carotid atherosclerosis, specifically regarding mortality and major adverse cardiovascular events (MACE).
Prospective observational study of patients with ≥50% internal carotid artery stenosis undergoing carotid endarterectomy from 2020 to 2023.
Cohort included 62 symptomatic and 32 asymptomatic patients, followed for 1 year.
Cox regression analyses assessed associations with mortality and MACE.
Higher LDL susceptibility to oxidation associated with increased mortality (aHRx1 min-increase=0.71, p=0.024).
Lower HDL cholesterol linked inversely with MACE (HRx1 mmol/L-increase=0.02, p=0.024).
Increased triglyceride content in HDL positively associated with MACE (aHRx1 %-increase=2.13, p<0.001).

Study Design

Type

Observational (n=94)

Structured PICO

Do HDL and LDL quality parameters predict mortality and MACE in patients with carotid atherosclerosis?

Population

94 patients with ≥50% internal carotid artery stenosis undergoing carotid endarterectomy from 2020 to 2023 (62 symptomatic with recent stroke, 32 asymptomatic with no stroke within 6 months).

Intervention

HDL and LDL quality parameters (lipoprotein composition, LDL resistance to oxidation, aggregated LDL)

Outcome

Mortality and three-point MACE (stroke, myocardial infarction, and vascular death)composite

Main Result

Effect estimate: aHR 2.13

p-value: p=<0.001

Cite This Study

synapsesocial.com/papers/69fd7f4fbfa21ec5bbf07d98 https://doi.org/10.1093/esj/aakag023.814

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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