Oxidized Low-Density Lipoprotein to High-Density Lipoprotein Ratio Predicts Recurrent Stroke in Minor Stroke or Transient Ischemic Attack

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Background and Purpose—

Oxidized low-density lipoprotein (oxLDL) level is thought to be associated with recurrent stroke. We aimed to investigate the association between oxLDL to high-density lipoprotein (HDL) ratio and recurrent stroke in patients with minor stroke or transient ischemic attack.


The study included 3019 patients with minor ischemic stroke or high-risk transient ischemic attack from the CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events). Baseline oxLDL and HDL levels were measured. 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 association between oxLDL/HDL and recurrent stroke was analyzed by using Cox proportional hazards.


Patients in the highest oxLDL/HDL quartile had a higher risk of recurrent stroke within 90 days (hazards ratio, 1.50; 95% CI, 1.08–2.08) compared with the lowest quartile after adjusting relevant confounding factors (P=0.02). Similar results were found for secondary outcomes (P<0.05 for all). There were no significant interaction between oxLDL/HDL and use of statins agents.


Higher serum oxLDL/HDL level in minor stroke or transient ischemic attack was associated with increased risk of recurrent stroke in 90 days and 1 year. OxLDL/HDL may act as a powerful indicator of recurrent stroke in patients with minor stroke or transient ischemic attack.

Clinical Trial Registration—

URL: http://www.clinicaltrials.gov. Unique identifier: NCT00979589.

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