Correlation between Remnant Cholesterol and the Risk of Ischemic Stroke Recurrence and Its Predictive Value

Background Serum remnant cholesterol (RC) is associated with the onset of ischemic stroke (IS). However, studies on the correlation between RC levels and recurrent IS are limited, and the predictive value of RC in recurrent IS has not been analyzed. Objective To investigate the correlation between serum RC and the recurrence of IS, and to evaluate the predictive value of RC levels in recurrent IS by detecting serum RC levels in patients with IS. Methods Patients diagnosed as IS and hospitalized in the First Affiliated Hospital of Nanchang University, the Second Affiliated Hospital of Nanchang University, the Second Hospital of Nanchang, and the Third Hospital of Nanchang from March 2019 to March 2021 were included in the study. Relevant clinical information within 48 hours of admission was collected. All patients were followed up for 12 months to record the cases of recurrent IS. Cox regression and Restricted Cubic Spline (RCS) were performed to identify the correlation between RC levels and recurrent IS. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of RC levels in recurrent IS. Results A total of 1 023 eligible patients were included in the study, and 107 (10.46%) of them experienced IS recurrence within 1 year. Multivariable Cox regression analysis showed that high RC was an independent risk factor for recurrent IS (HR=2.709, 95%CI=1.150-6.382; P<0.05). There was a nonlinear positive dose-response relationship between RC levels and the risk of recurrent IS (P-Nonlinear=0.019 3). The area under the curve (AUC) of RC in discriminating 1-year recurrence of IS was 0.687 (95%CI=0.631-0.743), with the optimal cutoff of 0.58 mmol/L. There was a significant difference in the AUC between the combination detection of RC and the Essen Stroke Risk Score (ESRS) versus ESRS alone in discriminating 1-year recurrence of IS (Z=2.356 2, P<0.05) . Conclusion High RC is an independent risk factor for recurrent IS, showing a predictive value in the recurrence of IS.