Small, dense low-density lipoprotein (sdLDL) and small-sized high-density lipoprotein
(HDL) particles are established risk factors for ischemic heart disease. However,
their clinical significance for acute ischemic stroke (AIS) is uncertain. This study
evaluates associations of LDL and HDL particle sizes and subclasses with AIS risk
and short-term mortality after AIS.
Two hundred AIS patients hospitalised for first-in-a-lifetime stroke and 162 apparently
healthy controls were included in the study. LDL and HDL particles were separated
by gradient gel electrophoresis and serum lipid parameters were measured by standard
laboratory methods. Baseline characteristics of LDL and HDL particles were evaluated
for the prediction of AIS and short-term mortality after AIS.
AIS patients had significantly more LDL III and IVb, but less LDL I and II particles.
They also had significantly smaller HDL size, more HDL 3a, 3b and 3c and less HDL
2b subclasses. The relative content of both sdLDL and small-sized HDL particles was
significantly increased in patients (P<0.001 and P<0.001, respectively). In addition,
sdLDL was significantly higher in AIS fatalities (n=25) compared with survivors (n=175,
P<0.05). Increased sdLDL was a significant predictor of AIS (OR=4.31; P<0.001) and
in-hospital mortality after AIS (OR=5.50; P<0.05). The observed relationships persisted
after adjustment for conventional risk factors.
AIS is associated with adverse distributions of LDL and HDL subclasses. In addition,
short-term mortality after AIS is associated with increased sdLDL particles. Our results
indicate that sdLDL is an independent predictor of both AIS onset and consecutive
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