Predictive Value of Blood Lipids in Carotid Plaque Stability in Patients with Large Atherosclerotic Cerebral Infarction

YAN Hua; GONG Liusheng; WANG Tingting; LIN Yan

doi:10.3639/i.issn.2095-3097.2025.02.014

Abstract：Objective To explore the predictive value of blood lipids in carotid plaque stability in patients with large atherosclerotic(LAA)cerebral infarction.Methods A total of 115 patients with LAA cerebral infarction in the Jianyang City People's Hospital from January 2022 to July 2024 were retrospectively selected.All patients were examined for blood lipids,includingtriglyceride(TG),total cholesterol(TC),and low/high density lipoprotein cholesterol(LDL-C/HDL-C).Carotid plaque status was assessed by ultrasonography,and patients were then divided into the stable group(no plaque+stable plaque)and unstable group(unstable plaque).Baseline data and blood lipid levels were compared between the two groups.The relevant data of the two groups were compared to analyze the influencing factors for plaque stability by multivariate stepwise Logistic regression analysis.The predictive efficacy of blood lipids on plaque stability was analyzed by plotting the receiver operating characteristic(ROC)curve.Results TC and LDL-C in the unstable group were significantly higher than those of the stable group,and HDL-C was significantly lower(P＜0.05).The proportion of patients years old,smoking history,levels of hypersensitive C-reactive protein(hs-CRP),HbA1c and homocysteine(Hcy)in the unstable group were significantly higher than those of the unstable group(P＜0.05).Logistic Results showed that LDL-C(OR=5.298,95％CI:2.960-9.482),HDL-C(OR=0.194,95％CI:0.091-0.411),hs-CRP(OR=4.635,95％CI:1.624-13.226),HbA1c(OR=2.474,95％CI:1.207-5.069)and Hcy(OR=4.281,95％CI:1.853-9.885)were independent factors affecting the stability of carotid plaque in patients with LAA cerebral infarction(P＜0.05).ROC curve showed that the sensitivity of LDL-C,HDL-C and their combination in predicting plaque stability was 72.30％,74.50％and 91.50％,with the specificity of 77.90％,66.20％and 64.70％,and the area under the curve(AUC)of 0.797,0.783 and 0.890,respectively(P＜0.05).Conclusion LDL-C and HDL-C are independent factors affecting the stability of carotid plaque in patients with LAA cerebral infarction,and the combined measurement of LDL-C and HDL-C levels can better predict the plaque stability.