Association analysis between remnant cholesterol and acute ischemic stroke for severity and short-term outcome

Abstract Background Elevated remnant cholesterol (RC) levels are associated with an increased risk of acute ischemic stroke (AIS). Our study aimed to explore the association between RC and stroke severity and short-term clinical outcome in AIS patients. Methods Patients diagnosed with AIS and admitted to the Central Hospital of Dalian University of Technology from August 2024 to November 2024 were enrolled. Stroke severity was assessed using the National Institute of Health Stroke Scale. Short-term outcome was evaluated using the modified Rankin Scale at discharge or 14 days after onset. Multivariate logistic regression analysis and exploratory subgroup analysis were conducted to evaluate the association between RC levels and stroke severity and short-term outcome. Results No significant association was found between RC and either stroke severity or short-term outcome in between-group comparison or multivariate logistic regression analysis. However, exploratory subgroup analysis showed that among patients with combined intracranial and extracranial arterial stenosis, higher RC levels were independently associated with poor short-term outcomes, with each 1 mmol/L increase in RC conferring a 23% higher risk of poor outcome ( P trend < 0.05). Conclusions RC was not significantly associated with stroke severity or short-term outcomes overall. The exploratory finding of a potential association in patients with combined intracranial and extracranial artery stenosis requires independent validation in future studies.