Traditional Lipid Ratios and Carotid Atherosclerosis in Patients with Ischemic Stroke

INTRODUCTION: Traditional lipid ratios were considered as robust predictors of cardiovascular disease risk. However, the relationships between traditional lipid ratios and atherosclerosis in the setting of ischemic stroke remain unclear. We aimed to explore the associations between traditional lipid ratios and carotid atherosclerosis in patients with ischemic stroke. METHODS: A total of 1,612 patients with ischemic stroke from 22 hospitals were included in this analysis. Traditional lipid ratios included Castelli's risk index-I (CRI-I), Castelli's risk index-II (CRI-II), and atherogenic coefficient (AC). Logistic regression models were used to assess the relationships between traditional lipid ratios and carotid atherosclerosis. RESULTS: The multivariable-adjusted odds ratios (ORs) (95% confidence intervals [CIs]) in quartile 4 versus quartile 1 of CRI-I, CRI-II, and AC were 1.65 (1.14-2.38), 1.48 (1.03-2.14), and 1.65 (1.14-2.38) for carotid atherosclerosis. Furthermore, the ORs (95% CIs) for the highest quartile of CRI-I, CRI-II, and AC were 1.51 (1.09-2.09), 1.38 (0.99-1.90), and 1.51 (1.09-2.09) for abnormal mean cIMT and were 1.60 (1.17-2.18), 1.59 (1.17-2.16), and 1.60 (1.17-2.18) for abnormal maximum cIMT, respectively. Restricted cubic spline models indicated that there were dose-response relationships between CRI-I, CRI-II, and AC and carotid atherosclerosis and abnormal cIMT (all P for linearity <0.001). Additionally, CRI-I, CRI-II, and AC offered incremental predictive capacity for carotid atherosclerosis beyond established risk factors, shown by increase in net reclassification improvement and integrated discrimination improvement (all p < 0.05). CONCLUSION: Elevated traditional lipid ratios were positively associated with carotid atherosclerosis in patients with ischemic stroke, supporting that these lipid ratios could be promising atherosclerotic predictors.