Treatment with statins appears to reduce plasma levels of oxidized LDL after acute ischemic stroke, suggesting that plasma oxidized LDL may serve as a standard biomarker for stroke outcome, according to findings of a prospective study.
Researchers assessed 120 consecutive patients who presented with acute ischemic stroke to a single hospital in Taiwan between October 2012 and April 2013. Stroke diagnosis was ascertained through clinical examination, neurologic findings and the results of brain MRI with diffusion-weighted images. Patients were aged 18 to 85 years and assigned to receive (n=55) or not receive a statin (n=65) according to serum LDL cholesterol levels after the stroke. Patients with evidence of atherosclerosis and LDL levels of 100 mg/dL or higher were prescribed statins. An at-risk control group that consisted of 80 age- and gender-matched participants without clinical evidence of acute cerebral infarction also was included.
Patients underwent full neurologic examinations at the initiation of the study and during follow-up. The researchers collected blood samples from the stroke patients within 48 hours of the stroke (designated as day 1), as well as on day 7 and day 30. The blood samples were assayed for total HDL, LDL cholesterol and triglycerides. Plasma oxidized LDL levels were determined using the mAb-4E6-based enzyme-linked immunosorbent assay (Mercodia).
Stroke patients had significantly higher plasma oxidized LDL levels than those in the control group (P< .001). However, although oxidized LDL levels were similar between statin recipients and non-recipients, oxidized LDL was significantly lower among those taking statins on day 7 and day 30 vs. those without statin treatment (P<.01). Adjustment for covariates, including high-sensitivity C-reactive protein, white blood cell count, NIH Stroke Scale (NIHSS), serial plasma oxidized LDL and other risk factors of acute ischemic stroke, did not significantly alter these results.
Researchers observed positive correlations between plasma oxidized LDL and blood total cholesterol, LDL cholesterol and HbA1c. NIHSS score (OR=1.55; 95% CI, 1.02-1.18) and oxidized LDL level at admission (OR=1.09; 95% CI, 1.02-1.18) were the only evaluated potential risk factors independently linked to 3-month outcomes.
“Our study demonstrates that statin therapy reduces plasma [oxidized] LDL level,” the researchers wrote. “The plasma [oxidized] LDL may be a better predictor than serum LDL, [high-sensitivity] CRP or [white blood cell] counts in blood after [acute ischemic stroke]. Therefore, assay of plasma [oxidized] LDL should be added as a predictor among the panel of conventional biomarkers in stroke outcome.”
Disclosure: The researchers report no relevant financial disclosures.