Low HDL-C Level Is Associated with the Development of Intracranial Artery Stenosis: Analysis from the Chinese IntraCranial AtheroSclerosis (CICAS) Study

Abstract

BackgroundIntracranial atherosclerotic stenosis (ICAS) is an important cause of ischemic stroke worldwide. The role of high-density lipoprotein cholesterol (HDL-C) or low-density lipoprotein cholesterol (LDL-C) in the development of ICAS remains to be elucidated. In the current study, we investigated the relationship of HDL-C level and the risk of developing ICAS in Chinese patients with acute ischemic stroke.MethodsFrom October 2007 to June 2009, a total of 1,984 consecutive ischemic stroke patients were evaluated for the presence of symptomatic ICAS by magnetic resonance angiography (MRA). Patients were classified into two groups: intracranial steno-occlusion (ICAS group, n = 888) and non-intracranial stenosis (NICAS group, n = 1096). Serum lipid profiles were analyzed and compared between the ICAS and NICAS group.ResultsSignificantly more patients in ICAS group had low HDL-C level (51.6%) than in the NICAS group (42.9%, P<0.001). The observed association remained significant after adjustment for conventional risk factors [(adjusted OR 1.36; 95%CI (1.13–1.63)]. Such predictive value of low level HDL-C persisted even when LDL-C was at very low level(<1.8 mmol/L). Patients in the lowest serum HDL-C quartile (<0.96 mmol/L) had the highest risk of developing ICAS [adjusted OR 1.52; 95%CI (1.17–1.98)] compared to patients in the highest serum HDL-C quartile (≥1.32 mmol/L) after adjustments for the covariates.ConclusionsLow HDL-C level is strongly associated with the development of ICAS. There was an inverse relationship between the level of HDL-C and the risk of developing ICAS.

Interobserver Reproducibility of Signal Intensity Ratio on Magnetic Resonance Angiography for Hemodynamic Impact of Intracranial Atherosclerosis

“…3,10 Symptomatic ICASs (50%–99%, Warfarin–Aspirin Symptomatic Intracranial Disease criteria 11 ) in one of the following arterial segments identified on TOF MRA were evaluated in the present study: intracranial portion of internal carotid artery (ICA), M1 segment of middle cerebral artery (MCA-M1), or basilar artery (BA).…”

Importance of lipid ratios for predicting intracranial atherosclerotic stenosis

“…Low-density lipoprotein cholesterol (LDL-C) is associated mainly with ECAS [4]. In Chinese populations, high-density lipoprotein-cholesterol (HDL-C) [5], non-high-density lipoprotein-cholesterol (non-HDL-C) [6] and total cholesterol (TC) [7] levels are associated with an increased risk of ICAS. One study based on a Korean population revealed the importance of hypercholesterolemia in ICAS in men [8].…”

Protective and Indicating Effect of Indirect Bilirubin in Intracranial or Extracranial Artery Atherosclerotic Stenosis Progresses

“…Intracranial atherosclerotic stenosis (ICAS) is associated with 8% to 10% of all ischemic strokes in the United States, but accounts for 33% to 54% of all ischemic strokes in Asia. In China, ICAS may be the cause of 37% to 51% of all strokes or transient ischemic attacks (TIA) [5]. These statistics highlight the importance of understanding the mechanisms involved in the development and elimination of atherosclerotic stenosis.…”