Prognostic value of lipid variability for recurrence and mortality in elderly patients with acute ischemic cerebrovascular disease

脂质变异性对老年急性缺血性脑血管疾病患者复发和死亡率的预后价值

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Abstract

OBJECTIVE: To investigate the relationship between lipid variability and the risk of recurrence and mortality during the acute phase of ischemic cerebrovascular disease (ICD) in elderly patients. METHODS: Clinical data, lipid profiles, and follow-up information were retrospectively collected from 149 elderly ICD patients who underwent at least three lipid measurements (non-baseline) at The Third People's Hospital of Hefei (The Third Clinical College of Anhui Medical University) from May 2021 to May 2024. Lipid indices included low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglycerides (TG). Variability was assessed using standard deviation (SD), coefficient of variation (CV), and variability independent of the mean (VIM). Follow-up concluded in May 2024. Patients were classified into no-recurrence, recurrence, and death groups. Logistic multivariate regression analysis was used to identify risk factors for recurrence and death. Receiver operating characteristic (ROC) curve analyses were applied to assess the predictive value of lipid variability. RESULTS: Variabilities in LDL-C, HDL-C, TC, and TG were significantly higher in the recurrence and death groups compared to the no-recurrence group. Logistic regression analysis identified lipid variability indices as independent risk factors for recurrence and death. ROC analysis furtherdemonstrated their predictive value. CONCLUSION: Variabilities in LDL-C, HDL-C, TC, and TG are independent risk factors for recurrence and death in elderly ICD patients. Combined analysis of lipid variability enhances diagnostic accuracy and may improve the prognostic assessment in this population.

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