Abstract 137: Noninvasive Fractional Flow on MRA and Recurrent Stroke: SPS3 Trial

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Makoto Nakajima ◽  
Nobuyuki Ohara ◽  
Lesly A Pearce ◽  
Edward Feldmann ◽  
Carlos Bazan ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Recurrent Stroke ◽  
Cox Proportional Hazards ◽  
Blood Pressure Target ◽  
Lacunar Stroke ◽  
Vascular Territory ◽  
Fractional Flow ◽  
Stroke Patients ◽  
Tof Mra ◽  
Flow Reserve

Background and Purpose: Noninvasive fractional flow reserve (FFR) on time-of-flight magnetic resonance angiography (TOF-MRA) may be used to identify high-risk intracranial lesions. We tested whether FFR was associated with vascular territory of the qualifying lacunar stroke in participants of the Secondary Prevention of Small Subcortical Strokes (SPS3) trial and the utility of FFR for predicting recurrent stroke during the trial. Methods: SPS3 was a randomized trial investigating optimal blood pressure target and antiplatelet regimen in patients with recent, symptomatic, MRI-confirmed lacunar stroke patients TOF-MRA proximate to study entry was adequate and available for 2169 of 3020 study patients. Signal intensity (SI) was measured in the background, and proximal and distal aspects of 7 intracranial arteries (internal carotid, middle cerebral, basilar, and vertebral). Adjusted FFR was then calculated in each artery: FFR = [distal SI - background SI] / [proximal SI - background SI] and divided into quartiles by artery. Associations between the vascular territory of the qualifying infarct and the FFR quartile of the relevant artery were investigated using contingency tables and chi-square tests. Risks for recurrent stroke associated with FFR quartiles were evaluated using Cox Proportional Hazards models (model adjusted for assigned treatment groups). Results: Mean age of the 2169 patients included was 63 yr with 63% male; hypertension, diabetes, and prior lacunar stroke were present in 75%, 36%, and 10% respectively. Median FFRs varied by artery with the lowest in the basilar (0.793) and highest in the middle cerebral arteries (left 1.154; right 1.176). A recurrent stroke occurred in 195 patients during a mean follow-up of 3.5 years (annualized rate 2.5% per patient-year).No significant association was found between the FFR tertiles and the vascular territory of the qualifying infarct. Quartiles of adjusted FFR in any of the 7 arteries were not found to be predictive of recurrent stroke. Conclusion: In this large well-characterized cohort of lacunar stroke patients, FFR was not associated with the location of the qualifying subcortical infarct and did not predict the risk of recurrent stroke.

Abstract 213: Cerebral Microbleeds in 1278 Lacunar Stroke Patients: The Secondary Prevention of Small Subcortical Strokes (SPS3) Trial

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Ashkan Shoamanesh ◽  
Lesly A Pearce ◽  
Carlos Bazan ◽  
Luciana Catanese ◽  
Leslie A McClure ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Recurrent Stroke ◽  
Large Population ◽  
Cerebral Microbleeds ◽  
Stroke Recurrence ◽  
Blood Pressure Target ◽  
Lacunar Stroke ◽  
Stroke Patients ◽  
Increased Risk ◽  
History Of

Background: Cerebral microbleeds (CMBs) are radiographic markers of cerebral small vessel disease (CSVD) reported to independently predict recurrent stroke and mortality. However, characterization of CMBs in a large population of pure CSVD is lacking. We aimed to characterize CMBs in a well-defined population of lacunar stroke patients, and assess the relationship between CMBs and recurrent stroke and death. Methods: SPS3 was a randomized trial investigating optimal blood pressure target and antiplatelet regimen in 3020 patients with recent, symptomatic, MRI-confirmed lacunar stroke. CMBs were rated as per the Brain Observer MicroBleed Scale in all participants who had an interpretable axial T2*- GRE sequence available as part of their baseline MRI (n=1278, intra-rater reliability for + CMB 91% agreement, Kappa = 0.82). Results: CMBs were present in 30% of 1278 patients (mean age 63 y, 65% male, 75% history of hypertension). CMBs were lobar in 21%, deep in 44%, and mixed in 35% of cases. Of patients with CMBs, most (57%) had 1-2 CMBs, 31% had 3-10, and 12% >10. Male gender (OR 1.7, 95% CI 1.3-2.3), history of hypertension (1.6, 1.2-2.3), increased systolic blood pressure (1.2 per 20 mmHg, 1.1-1.4), non-diabetic (1.4, 1.1-1.9), multiple lacunar infarcts (1.9, 1.5-2.5) and moderate (1.7, 1.2-2.3) or severe (4.2, 3.0-5.9) white matter hyperintensities on MRI were independently associated with the odds of having CMBs in multivariable logistic regression. During a mean follow-up of 3.3 y, overall stroke recurrence was 2.5% per patient-y. In comparison to patients without CMBs, those with CMBs had a two-fold increased risk of stroke (HR 2.1, 1.4-3.1), after adjusting for assigned treatments and risk factors, whereas those with >10 CMBs had a four-fold increased risk (HR 4.0, 1.8-8.7). CMBs were not a risk factor for death (HR 1.2, 0.8-2.0). There were no interactions between CMBs and treatment assignments. Conclusions: In this largest reported cohort of lacunar stroke investigating CMBs, CMBs were highly prevalent and an independent predictor of stroke recurrence. Accordingly, patients with lacunar stroke and CMBs likely represent a more aggressive form of CSVD in need of efficacious therapeutic strategies. Further research is warranted in this field.

scholarly journals Endothelial and leukocyte-derived microvesicles and cardiovascular risk after stroke—PROSCIS-B

Neurology ◽  
2020 ◽  
pp. 10.1212/WNL.0000000000011223
Author(s):  
Shufan Huo ◽  
Nicolle Kränkel ◽  
Alexander Heinrich Nave ◽  
Pia Sophie Sperber ◽  
Jessica Lee Rohmann ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Proportional Hazards ◽  
Recurrent Stroke ◽  
Cox Proportional Hazards ◽  
Blood Levels ◽  
Stroke Patients ◽  
Link Type ◽  
All Cause Mortality ◽  
The Impact

ObjectiveTo determine the role of circulating microvesicles (MV) on long-term cardiovascular outcomes after stroke, we measured them in first-ever stroke patients with a three-year follow-up.MethodsIn the PROSpective Cohort with Incident Stroke Berlin (PROSCIS-B), patients with first-ever ischemic stroke were followed for 3 years. The primary combined endpoint consisted of recurrent stroke, myocardial infarction, and all-cause mortality. Citrate-blood levels of endothelial MV (EMV), leukocyte-derived MV (LMV), monocytic MV (MMV), and platelet-derived MV (PMV) were measured using flow cytometry. Kaplan-Meier curves and adjusted Cox proportional hazards models were used to estimate the effect of MV levels on the combined endpoint.ResultsFive hundred seventy-one patients were recruited (median age 69 years; 39% female; median NIHSS 2, interquartile range 1–4) and 95 endpoints occurred. Patients with levels of EMV [adjusted hazard ratio (HR) = 2.5, 95% confidence interval (CI) 1.2–4.9] or LMV (HR = 3.1, 95% CI 1.4–6.8) in the highest quartile were more likely to experience an event than participants with lower levels using the lowest quartile as reference category. The association was less pronounced for PMV (HR = 1.7, 95% CI 0.9–3.2) and absent for MMV (HR = 1.1, 95% CI 0.6–1.8).ConclusionHigh levels of EMV and LMV after stroke were associated with worse cardiovascular outcome within 3 years. These results reinforce that endothelial dysfunction and vascular inflammation affect the long-term prognosis after stroke. EMV and LMV might play a role in risk prediction for stroke patients.Study registrationclinicaltrials.gov/ct2/show/NCT01363856. UID: NCT01363856.Classification of evidenceThis study provides Class II evidence of the impact of MV levels on subsequent stroke, myocardial infarction or all-cause mortality in survivors of mild stroke.

Influence of the extent of vascular territory on fractional flow reserve measurements

2002 ◽  
Vol 57 (5) ◽  
pp. 349-351
Author(s):  
Michel DE CEUNINCK ◽  
Marc CLAEYS ◽  
Johan BOSMANS ◽  
Christiaan VRINTS
Keyword(s):  
Fractional Flow Reserve ◽  
Vascular Territory ◽  
Fractional Flow ◽  
Flow Reserve

Cognitive Impairment after Lacunar Stroke and the Risk of Recurrent Stroke and Death

2021 ◽  
pp. 1-7
Author(s):  
Abraham Kwan ◽  
Jingkai Wei ◽  
N. Maritza Dowling ◽  
Melinda C. Power ◽  
Zurab Nadareshvili ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Memory Impairment ◽  
Recurrent Stroke ◽  
Cox Proportional Hazards ◽  
Hazard Ratio ◽  
Cognitive Screening ◽  
Lacunar Stroke ◽  
Domain Specific ◽  
Risk Of Death ◽  
Increased Risk

Introduction: Patients with poststroke cognitive impairment appear to be at higher risk of recurrent stroke and death. However, whether cognitive impairment after lacunar stroke is associated with recurrent stroke and death remains unclear. We assessed whether global or domain-specific cognitive impairment after lacunar stroke is associated with recurrent stroke and death. Methods: We considered patients from the Secondary Prevention of Small Subcortical Strokes (SPS3) trial with a baseline cognitive exam administered in English by certified SPS3 personnel, 14–180 days after qualifying lacunar stroke. We considered a baseline score of ≤86 on the Cognitive Assessment Screening Instrument to indicate global cognitive impairment, <10 on the Clock Drawing on Command test to indicate executive function impairment, and domain-specific summary scores in the lowest quartile to indicate memory and nonmemory impairment. We used Cox proportional hazards models to estimate the association between poststroke cognitive impairment and subsequent risk of recurrent stroke and death. Results: The study included 1,528 participants with a median enrollment time of 62 days after qualifying stroke. During a mean follow-up of 3.9 years, 11.4% of participants had recurrent stroke and 8.2% died. In the fully adjusted models, memory impairment was independently associated with an increased risk of recurrent stroke (hazard ratio, 1.48; 95% confidence interval [95% CI]: 1.04–2.09) and death (hazard ratio, 1.87; 95% CI: 1.25–2.79). Global impairment (hazard ratio, 1.66; 95% CI: 1.06–2.59) and nonmemory impairment (hazard ratio, 1.74; 95% CI: 1.14–2.67) were associated with an increased risk of death. Discussion/Conclusion: After lacunar stroke, memory impairment was an independent predictor of recurrent stroke and death, while global and nonmemory impairment were associated with death. Cognitive screening in lacunar stroke may help identify populations at higher risk of recurrent stroke and death.

Abstract T P142: Mortality and Stroke Recurrence in Obese Stroke Patients: The Obesity Paradox in a London-Based Population

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Filomena Gomes ◽  
Peter W Emery ◽  
Christine E Weekes
Keyword(s):  
Waist Circumference ◽  
Proportional Hazards ◽  
Hospital Admissions ◽  
Recurrent Stroke ◽  
Normal Weight ◽  
Cox Proportional Hazards ◽  
National Database ◽  
Stroke Recurrence ◽  
Recurrence Rates ◽  
Post Stroke

INTRODUCTION Several studies have shown a paradoxical association between body mass index (BMI) and mortality after stroke. However, the association between BMI, waist circumference (WC) and mortality and stroke recurrence is unclear. This study aimed to determine the associations between BMI, WC and mortality and stroke recurrence at 6 months post stroke. METHODS Patients were recruited from consecutive admissions at 2 hyper-acute stroke units in London and were classified into 4 categories of BMI (underweight, normal weight, overweight and obese) and quartiles of WC. Outcomes were obtained for each patient through a national database that contains details of all hospital admissions. Chi-square tests were used to compare mortality and stroke recurrence rates. Cox Proportional Hazards Models were used to compare mortality risk and survival curves between different BMI categories and WC quartiles. RESULTS Of 543 recruited patients, 51% were males and 87% had an ischaemic stroke, with a mean age of 74.7 years (range 22-99). There were significant inverse associations between BMI and WC and risk of mortality at 6-months post-stroke (see table) ( p=0.001 and p=0.04, respectively). After adjusting for possible confounders (age, ethnicity, gender, severity and type of stroke, stroke risk factors), these associations were attenuated ( p=0.06 for BMI and p=0. 11 for WC). No significant differences were found in stroke recurrence rates between BMI groups (underweight 3.7%, normal weight 3.8%, overweight 4.5%, obese 2.8%; p=0.91) or WC quartiles (Q1 2.8%, Q2 5.1%, Q3 3.5%, Q4 3.6%; p=0.83). CONCLUSION After a stroke, being obese and having a larger waist circumference was associated with reduced mortality but did not affect the risk of a recurrent stroke.

One-Year Risk of Recurrent Stroke and Death Associated with Vertebrobasilar Artery Stenosis and Occlusion in a Cohort of 10,515 Patients

2019 ◽  
Vol 47 (1-2) ◽  
pp. 40-47 ◽  
Author(s):  
Adnan I. Qureshi ◽  
Mushtaq H. Qureshi ◽  
Li-Ming Lien ◽  
Jiunn-Tay Lee ◽  
Jiann-Shing Jeng ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Recurrent Stroke ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Large Artery ◽  
Stroke Registry ◽  
Risk Of Death ◽  
Vertebrobasilar Artery

Background: The natural history of vertebrobasilar artery (VBA) stenosis or occlusion remains understudied. Methods: Patients with diagnosis of ischemic stroke or transient ischemic attack (TIA) who were noted to have VBA stenosis based on computed tomography or magnetic resonance imaging or catheter-based angiogram were selected from Taiwan Stroke Registry. Cox proportional hazards model was used to determine the hazards ratio (HR) of recurrent stroke and death within 1 year of index event in various groups based on severity of VBA stenosis (none to mild: 0–49%; moderate to severe: 50–99%: occlusion: 100%) after adjusting for differences in demographic and clinical characteristics between groups at baseline evaluation. Results: None to mild or moderate to severe VBA stenosis was diagnosed in 6972 (66%) and 3,137 (29.8%) among 10,515 patients, respectively, and occlusion was identified in 406 (3.8%) patients. Comparing with patients who showed none to mild stenosis of VBA, there was a significantly higher risk of recurrent stroke (HR 1.21, 95% CI 1.01–1.45) among patients with moderate to severe VBA stenosis. There was a nonsignificantly higher risk of recurrent stroke (HR 1.49, 95% CI 0.99–2.22) and significantly higher risk of death (HR 2.21, 95% CI 1.72–2.83), among patients with VBA occlusion after adjustment of potential confounders. Conclusions: VBA stenosis or occlusion was relatively prevalent among patients with TIA or ischemic stroke and associated with higher risk of recurrent stroke and death in patients with ischemic stroke or TIA who had large artery atherosclerosis.

Abstract WP424: Efficacy Of Antiplatelet Therapy For Secondary Stroke Prevention Following Lacunar Stroke: A Meta-analysis And Pooled Analysis Of Randomized Controlled Trials

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Ashkan Shoamanesh ◽  
Chun Shing Kwok ◽  
Phyo K Myint ◽  
Yoon K Loke ◽  
Hannah Copley ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Antiplatelet Therapy ◽  
Stroke Prevention ◽  
Recurrent Stroke ◽  
Meta Analysis ◽  
Antiplatelet Agents ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
Lacunar Stroke ◽  
Stroke Patients

INTRODUCTION: The predominant underlying mechanism of lacunar stroke differs from that of other ischemic stroke subtypes. Accordingly, so may the ideal stroke prevention regimen. We aimed to evaluate the efficacy of different antiplatelet agents in lacunar stroke patients. Method: We searched MEDLINE, EMBASE and the Cochrane library for RCTs that evaluated antiplatelet therapy in patients with ischemic stroke. Trials which provided stroke recurrence rates in patients presenting with lacunar stroke, or where the data was obtainable from manuscript authors were included. In addition, we included the novel SPS3 trial’s antiplatelet arm data presented at the 2011 ISC. We performed pooled analysis to assess the crude frequency of recurrent stroke and a random effects meta-analysis. Results: Lacunar stroke data was available for 12 trials encompassing 35, 218 participants (mean age 65, 65% male). The pooled crude recurrent stroke rate was least for cilostazol monotherapy (6.2%), followed by ASA monotherapy (7.4%), clopidogrel monotherapy (8.6%), ASA/dipyridamole (8.6%) and greatest for ASA/clopidogrel therapy (9.1%). Rate ratios of lacunar stroke patients suggest no significant efficacy advantage for ASA [ASA vs placebo (RR 0.72, 95% CI 0.34-1.50; p=0.38)], ASA/clopidogrel [ASA/clopidogrel vs ASA (RR 0.80, 95% CI 0.62-1.03; p=0.08), ASA/clopidogrel vs clopidogrel (RR 0.95, 95% CI 0.79-1.15; p=0.63)], sarpogrelate [sarpogrelate vs ASA (RR 1.31, 95% CI 0.84-2.04; p=0.23)] and ASA/dipyridamole [ASA/dipyridamole vs ASA (RR 0.90, 95% CI 0.70-1.16; p=0.042)] for recurrent stroke. The results from Japanese trials evaluating the efficacy of cilostazol found that it is significantly better than both placebo (RR 0.51, 95% CI 0.30-0.85; p=0.01) and ASA (RR 0.70, 95% CI 0.51-0.96; p=0.03) in the secondary prevention of stroke. Conclusions: There seems to be no significant advantage among the various antiplatelet agents studied in lacunar stroke patients apart for cilostazol. However, this requires confirmation within large randomized trials outside of Japanese populations.

Abstract 3332: Fractional Flow Reserve (FFR) And MIBI SPECT: A comparison In Patients With Multi-vessel Coronary Disease

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Narbeh Melikian ◽  
Pieter De Bondt ◽  
Thomas Cuisset ◽  
Eric Wyffels ◽  
Jozef Bartunek ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Multivessel Disease ◽  
Vascular Territory ◽  
Weak Correlation ◽  
Fractional Flow ◽  
Vessel Disease ◽  
Segment Model ◽  
Flow Reserve ◽  
Perfusion Defects ◽  
Mibi Spect

INTRODUCTION In patients with angiographic 3 vessel disease only 29% have been reported to have perfusion defects. However the association between physiological evidence for ischemia per vessel derived from fractional flow reserve (FFR) and MIBI SPECT (SPECT) in multivessel disease (MVD) is unknown. We comapred this association in patients with MVD. METHOD In 84 vascular territories in 28 patients (mean age 63.9±9.8 years, LV ejection fraction 69±12%) with angiographic MVD (>50% stenosis in at least 2 vessels) results of SPECT (rest / stress adenosine) were compared to FFR measurements in each coronary vessel. AHA semi-quantitative 5 point scorning system using a 17-segment model was used to report SPECT scans. A FFR <0.80 was taken as evidence for ischemia. RESULTS MIBI was positive in at least 1 territory in 19 (67%) and FFR <0.80 in at least 1 territory in 23 (82%) of patients. 7 (25%) patients with no perfusion defect on SPECT had FFR <0.80 in at least 2 territories. The association between MIBI and FFR in each patient and per vascular territory are summarised below. Per patient there was no concordance between SPECT and FFR (Kappa −0.11) and per vascular territory there was poor concordance between SPECT and FFR (Kappa 0.23). In 8 (29%) patients both SPECT and FFR detected identical ischemic territories [mean number of ischemic territories: 1.5±0.9 for both; P=1.00]. In the remaining 20 patients in comparison to FFR, SPECT either underestimated [9 (32%) patients − mean number of ischemic territories, SPECT: 0.3±0.7, FFR: 1.9±0.6; P=0.001] or overestimated [11 (39%) patients -mean number of ischemic territories, MIBI: 2.0±1.0, FFR: 1.0±0.9; P=0.02] the number of ischemic territories. There was a weak correlation between severity of ischemia as assessed by SPECT in each vascular territory and the actual FFR value (r=0.34; P=0.001). CONCLUSION In patients with multivessel disease, the concordance between SPECT and FFR to localise hemodynamically significant stenosis is poor. Per Patient and per vascular territory comparison of MIBI SPECT and FFR

scholarly journals Serum Uric Acid Is Associated with Poor Outcome in Black Africans in the Acute Phase of Stroke

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Yacouba N. Mapoure ◽  
Chia Mark Ayeah ◽  
M. S. Doualla ◽  
H. Ba ◽  
Hugo B. Mbatchou Ngahane ◽  
...  
Keyword(s):  
Uric Acid ◽  
Acute Stroke ◽  
Serum Uric Acid ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Cox Proportional Hazards ◽  
Stroke Patients ◽  
Black African ◽  
Poor Outcome

Background.Prognostic significance of serum uric acid (SUA) in acute stroke still remains controversial.Objectives.To determine the prevalence of hyperuricemia and its association with outcome of stroke patients in the Douala General Hospital (DGH).Methods.This was a hospital based prospective cohort study which included acute stroke patients with baseline SUA levels and 3-month poststroke follow-up data. Associations between high SUA levels and stroke outcomes were analyzed using multiple logistic regression and survival analysis (Cox regression and Kaplan-Meier).Results.A total of 701 acute stroke patients were included and the prevalence of hyperuricemia was 46.6% with a mean SUA level of 68.625 ± 24 mg/l. Elevated SUA after stroke was associated with death (OR = 2.067; 95% CI: 1.449–2.950;p< 0.001) but did not predict this issue. However, an independent association between increasing SUA concentration and mortality was noted in a Cox proportional hazards regression model (adjusted HR = 1.740; 95% CI: 1.305–2.320;p< 0.001). Furthermore, hyperuricemia was an independent predictor of poor functional outcome within 3 months after stroke (OR = 2.482; 95% CI: 1.399–4.404;p= 0.002).Conclusion.The prevalence of hyperuricemia in black African stroke patients is quite high and still remains a predictor of poor outcome.

Oxidized low-density lipoprotein predicts recurrent stroke in patients with minor stroke or TIA

Neurology ◽  
2018 ◽  
Vol 91 (10) ◽  
pp. e947-e955 ◽  
Author(s):  
Anxin Wang ◽  
Jie Xu ◽  
Guojuan Chen ◽  
David Wang ◽  
S. Claiborne Johnston ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Recurrent Stroke ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cox Proportional Hazards ◽  
Minor Stroke ◽  
Low Density ◽  
Oxidized Low Density Lipoprotein ◽  
Vascular Events ◽  
Secondary Outcomes

ObjectiveTo investigate the association between oxidized low-density lipoprotein (oxLDL) and recurrent stroke in patients with minor stroke or TIA.MethodsIn the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events (CHANCE) trial, baseline oxLDL levels were blindly measured in plasma with the 4E6 antibody in the core laboratory. The primary outcome was any stroke within 90 days. The secondary outcomes included any stroke within 1 year and ischemic stroke and combined vascular events within 90 days and 1 year. The associations of oxLDL with recurrent stroke were analyzed by Cox proportional hazards.ResultsAmong 3,019 patients included in this study, the median (interquartile range) of oxLDL was 13.96 (6.65–28.81) μg/dL. After adjustment for conventional confounding factors, patients in the highest oxLDL quartile (≥28.81 μg/dL) had a higher risk of recurrent stroke within 90 days (hazard ratio 1.43, 95% confidence interval 1.03–1.98) compared to those in the lowest oxLDL quartile (<6.65 μg/dL). Similar results were found for secondary outcomes. We also found a J-shaped association between oxLDL and risk of each outcome. There were no significant interactions between oxLDL and low-density lipoprotein and use of dual antiplatelet, antihypertensive, antidiabetic, and statins agents.ConclusionsElevated oxLDL levels can independently predict recurrent stroke in patients with minor stroke or TIA.ClinicalTrials.gov identifier:NCT00979589.

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