Key result
Among acute ischemic stroke patients with high total cholesterol, female gender was significantly associated with increasing age (OR 1.028), higher BMI, and elevated HDL-C, whereas male gender was associated with coronary artery disease and history of substance abuse.
Why the study?
The specific relationship between demographic and clinical risk factors, total cholesterol, and resulting gender differences in acute ischemic stroke patients had not been investigated.
Observational (n=4,719)
No
Odds Ratio: 1.028 (95% CI 1.006–1.052)
p-value: p=0.014
There are significant gender-based disparities in demographic and clinical risk factors associated with different total cholesterol levels in acute ischemic stroke patients, highlighting the need for personalized therapeutic approaches.
Supports sex-specific AIS risk models; hypothesis-generating for cholesterol thresholds pending validation.
Men and women differ in their clinical risk factors with respect to various predictors of severity in acute ischemic stroke (AIS). High cholesterol is a risk factor for AIS and the mechanism by which high cholesterol levels lead to an AIS is well established. However, the specific relationship between demographic, clinical risk factors, total cholesterol, and the resulting gender difference in AIS patients is yet to be investigated. This study recruited AIS patients between January 2000 and June 2016 classified into normal, borderline or high total cholesterol (TC). Normal was defined as ≤200 mg/dl, borderline 200 to 239 mg/dl and high ≥240 mg/dl based on Adult Treatment Panel III (ATP III) Guidelines for the classification of TC levels. The logistic regression model was used to predict clinical risk factors associated within men and women AIS patients with different levels of TC. A total of 3532 AIS patients presented with normal TC, 760 patients with borderline TC and 427 patients with high TC. The high total cholesterol group was more likely to be women with increasing age (OR = 1.028, 95% CI, 1.006-1.052, P = .014), body mass index (BMI) (OR = 1.052, 95% CI, 1.004-1.102, P = .033), and high-density lipoprotein cholesterol (HDL-C) (OR = 1.039, 95% CI, 1.019-1.060, P < .001), while those with coronary artery disease (OR = 0.435, 95% CI, 0.234-0.809, P = .003), history of drug or alcohol abuse (OR = 0.261, 95% CI, 0.079-0.867, P = .028), increasing INR (OR = 0.187, 95% CI, 0.047-0.748, P = .018), and elevated diastolic blood pressure (OR = 0.982, 95% CI, 0.970-0.995, P = .006) were associated with being a male AIS patient. There were disparities in demographic and clinical risk factors associated with high TC levels in men when compared to women and more clinical risk factors were associated with high TC levels in men when compared to women with AIS. It is important to take into account specific clinical risk factors associated with gender-related differences in total cholesterol in AIS population to facilitate personalizing their therapeutic actions.
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Brechtel et al. (2020) conducted an observational in Acute ischemic stroke (n=4,719). High total cholesterol (≥240 mg/dl) vs. Normal (<200 mg/dl) and borderline (200-239 mg/dl) total cholesterol was evaluated on Association of increasing age with female gender in high total cholesterol AIS patients (OR 1.028, 95% CI 1.006-1.052, p=0.014). Among acute ischemic stroke patients with high total cholesterol, female gender was significantly associated with increasing age (OR 1.028), higher BMI, and elevated HDL-C, whereas male gender was associated with coronary artery disease and history of substance abuse.
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