Nutrition, metabolism, and cardiovascular diseases : NMCD · 2026
Clinical outcomes and safety profile of early low-density lipoprotein cholesterol target attainment in patients with atherosclerotic cerebral infarction: a prospective cohort study.
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Li Peixue, Tan Jing, Zhang Ce, Liu Ying, Lin Yongzhong
Аннотация
BACKGROUND AND PURPOSE: To evaluate the impact of early achievement of the low-density lipoprotein cholesterol (LDL-C) targets during the acute phase on clinical outcomes and safety in patients with atherosclerotic cerebral infarction, thereby providing evidence for optimizing the management strategy in the acute stage of stroke.
METHODS AND RESULTS: In this prospective cohort study, 187 patients were stratified into an Early Achievement (EA, n = 68) group or a Non-Achievement (NA, n = 119) group based on LDL-C target attainment at 7 days after treatment initiation. During the 90-day follow-up, the EA group showed a significantly lower incidence of major adverse cardio-cerebrovascular events (MACCE) (1.47% vs. 11.76%, RR = 0.103, P = 0.014) and a higher proportion of patients achieving favorable functional outcomes (modified Rankin Scale [mRS] score ≤2) (92.54% vs. 80.95%, RR = 1.178, P = 0.024) compared with the NA group. The average improvement in the mRS score at 90 days was greater in the EA group by 0.416 points (β = 0.416, P = 0.002). No significant between-group difference was found in early neurological deterioration (END), and no serious adverse events were reported (P > 0.05). Lipidomic analysis revealed more pronounced reductions in 26 lipid species/subclasses in the EA group after 7 days of treatment (all P < 0.05).
CONCLUSION: These results suggest that early achievement of LDL-C targets significantly reduces the incidence of MACCE in patients with atherosclerotic cerebral infarction, enhances neurological functional recovery in patients with AIS within 90 days, and demonstrates a favorable safety profile.
METHODS AND RESULTS: In this prospective cohort study, 187 patients were stratified into an Early Achievement (EA, n = 68) group or a Non-Achievement (NA, n = 119) group based on LDL-C target attainment at 7 days after treatment initiation. During the 90-day follow-up, the EA group showed a significantly lower incidence of major adverse cardio-cerebrovascular events (MACCE) (1.47% vs. 11.76%, RR = 0.103, P = 0.014) and a higher proportion of patients achieving favorable functional outcomes (modified Rankin Scale [mRS] score ≤2) (92.54% vs. 80.95%, RR = 1.178, P = 0.024) compared with the NA group. The average improvement in the mRS score at 90 days was greater in the EA group by 0.416 points (β = 0.416, P = 0.002). No significant between-group difference was found in early neurological deterioration (END), and no serious adverse events were reported (P > 0.05). Lipidomic analysis revealed more pronounced reductions in 26 lipid species/subclasses in the EA group after 7 days of treatment (all P < 0.05).
CONCLUSION: These results suggest that early achievement of LDL-C targets significantly reduces the incidence of MACCE in patients with atherosclerotic cerebral infarction, enhances neurological functional recovery in patients with AIS within 90 days, and demonstrates a favorable safety profile.