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Association of Lipids, Lipoproteins, and Apolipoproteins with Stroke Subtypes in an International Case Control Study (INTERSTROKE)

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dc.contributor.author O’donnell, M.J.
dc.contributor.author McQueen, M.
dc.contributor.author Sniderman, A.
dc.contributor.author Pare, G.
dc.contributor.author Wang, X.
dc.contributor.author Hankey, G.J.
dc.contributor.author Rangarajan, S.
dc.contributor.author Chin, S.L.
dc.contributor.author Rao-Melacini, P.
dc.contributor.author Ferguson, J.
dc.contributor.author Xavier, D.
dc.contributor.author Lisheng, L.
dc.contributor.author Zhang, H.
dc.contributor.author Pais, P.
dc.contributor.author Lopez-Jaramillo, P.
dc.contributor.author Damasceno, A.
dc.contributor.author Langhorne, P.
dc.contributor.author Rosengren, A.
dc.contributor.author Dans, A.L.
dc.contributor.author Elsayed, A.
dc.contributor.author Avezum, A.
dc.contributor.author Mondo, C.
dc.contributor.author Judge, C.
dc.contributor.author Diener, H.-C.
dc.contributor.author Ryglewicz, D.
dc.contributor.author Czlonkowska, A.
dc.contributor.author Pogosova, N.
dc.contributor.author Weimar, C.
dc.contributor.author Iqbal, R.
dc.contributor.author Diaz, R.
dc.contributor.author Yusoff, K.
dc.contributor.author Yusufali, A.
dc.contributor.author Oguz, A.
dc.contributor.author Penaherrera, E.
dc.contributor.author Lanas, F.
dc.contributor.author Ogah, O.S.
dc.contributor.author Ogunniyi, A.
dc.contributor.author Iversen, H.K.
dc.contributor.author Málaga Rodríguez, Germán Javier
dc.contributor.author Rumboldt, Z.
dc.contributor.author Oveisgharan, S.
dc.contributor.author Hussain, F.A.
dc.contributor.author Nilanont, Y.
dc.contributor.author Yusuf, S.
dc.contributor.author INTERSTROKE Investigators
dc.date.accessioned 2022-08-15T20:11:08Z
dc.date.available 2022-08-15T20:11:08Z
dc.date.issued 2022
dc.identifier.uri https://hdl.handle.net/20.500.12866/12016
dc.description.abstract Background and Purpose The association of dyslipidemia with stroke has been inconsistent, which may be due to differing associations within etiological stroke subtypes. We sought to determine the association of lipoproteins and apolipoproteins within stroke subtypes. Methods Standardized incident case-control STROKE study in 32 countries. Cases were patients with acute hospitalized first stroke, and matched by age, sex and site to controls. Concentrations of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (apoA1), and apoB were measured. Non-HDL-C was calculated. We estimated multivariable odds ratio (OR) and population attributable risk percentage (PAR%). Outcome measures were all stroke, ischemic stroke (and subtypes), and intracerebral hemorrhage (ICH). Results Our analysis included 11,898 matched case-control pairs; 77.3% with ischemic stroke and 22.7% with ICH. Increasing apoB (OR, 1.10; 95% confidence interval [CI], 1.06 to 1.14 per standard deviation [SD]) and LDL-C (OR, 1.06; 95% CI, 1.02 to 1.10 per SD) were associated with an increase in risk of ischemic stroke, but a reduced risk of ICH. Increased apoB was significantly associated with large vessel stroke (PAR 13.4%; 95% CI, 5.6 to 28.4) and stroke of undetermined cause. Higher HDL-C (OR, 0.75; 95% CI, 0.72 to 0.78 per SD) and apoA1 (OR, 0.63; 95% CI, 0.61 to 0.66 per SD) were associated with ischemic stroke (and subtypes). While increasing HDL-C was associated with an increased risk of ICH (OR, 1.20; 95% CI, 1.14 to 1.27 per SD), apoA1 was associated with a reduced risk (OR, 0.80; 95% CI, 0.75 to 0.85 per SD). ApoB/A1 (OR, 1.38; 95% CI, 1.32 to 1.44 per SD) had a stronger magnitude of association than the ratio of LDL-C/HDL-C (OR, 1.26; 95% CI, 1.21 to 1.31 per SD) with ischemic stroke (P<0.0001). Conclusions The pattern and magnitude of association of lipoproteins and apolipoproteins with stroke varies by etiological stroke subtype. While the directions of association for LDL, HDL, and apoB were opposing for ischemic stroke and ICH, apoA1 was associated with a reduction in both ischemic stroke and ICH. The ratio of apoB/A1 was the best lipid predictor of ischemic stroke risk. en_US
dc.language.iso eng
dc.publisher Korean Stroke Society
dc.relation.ispartofseries Journal of Stroke
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Stroke en_US
dc.subject Risk factor en_US
dc.subject Dyslipidemia en_US
dc.subject Lipoproteins en_US
dc.subject Apolipoproteins en_US
dc.subject Case-control en_US
dc.title Association of Lipids, Lipoproteins, and Apolipoproteins with Stroke Subtypes in an International Case Control Study (INTERSTROKE) en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.5853/jos.2021.02152
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#1.06.03
dc.relation.issn 2287-6405


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