{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:41:30Z","timestamp":1790700090329,"version":"4.1.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,8,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Recent trials have shown that low\u2010density lipoprotein cholesterol (LDL\u2010C) &lt;1.80\u00a0mmol\/L (&lt;70\u00a0mg\/dL) is associated with a reduced risk of major adverse cardiovascular events in White patients with ischemic stroke with atherosclerosis. However, it remains uncertain whether the findings can be generalized to Asian patients, or that similar LDL\u2010C targets should be adopted in patients with stroke without significant atherosclerosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We performed a prospective cohort study and recruited consecutive Chinese patients with ischemic stroke with magnetic resonance angiography of the intra\u2010 and cervicocranial arteries performed at the University of Hong Kong between 2008 and 2014. Serial postevent LDL\u2010C measurements were obtained. Risk of major adverse cardiovascular events in patients with mean postevent LDL\u2010C &lt;1.80 versus \u22651.80 mmol\/L, stratified by presence or absence of significant (\u226550%) large\u2010artery disease (LAD) and by ischemic stroke subtypes, were compared. Nine hundred four patients (mean age, 69\u00b112\u00a0years; 60% men) were followed up for a mean 6.5\u00b12.4\u00a0years (mean, 9\u00b15 LDL\u2010C readings per patient). Regardless of LAD status, patients with a mean postevent LDL\u2010C &lt;1.80\u00a0mmol\/L were associated with a lower risk of major adverse cardiovascular events (with significant LAD: multivariable\u2010adjusted subdistribution hazard ratio, 0.65; 95% CI, 0.42\u20130.99; without significant LAD: subdistribution hazard ratio, 0.53; 95% CI, 0.32\u20130.88) (both\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05). Similar findings were noted in patients with ischemic stroke attributable to large\u2010artery atherosclerosis (subdistribution hazard ratio, 0.48; 95% CI, 0.28\u20130.84) and in patients with other ischemic stroke subtypes (subdistribution hazard ratio, 0.64; 95% CI, 0.43\u20130.95) (both\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">A mean LDL\u2010C &lt;1.80\u00a0mmol\/L was associated with a lower risk of major adverse cardiovascular events in Chinese patients with ischemic stroke with and without significant LAD. Further randomized trials to determine the optimal LDL\u2010C cutoff in stroke patients without significant atherosclerosis are warranted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.021855","type":"journal-article","created":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T09:25:33Z","timestamp":1628328333000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Low\u2010Density Lipoprotein Cholesterol and Risk of Recurrent Vascular Events in Chinese Patients With Ischemic Stroke With and Without Significant Atherosclerosis"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8657-2418","authenticated-orcid":false,"given":"Kui\u2010Kai","family":"Lau","sequence":"first","affiliation":[{"name":"Division of Neurology Department of Medicine Queen Mary Hospital Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong"},{"name":"The State Key Laboratory of Brain and Cognitive Sciences University of Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan J.","family":"Chua","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine Queen Mary Hospital Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7463-7563","authenticated-orcid":false,"given":"Alexander","family":"Ng","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine Queen Mary Hospital Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian Yu\u2010Hin","family":"Leung","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine Queen Mary Hospital Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6946-344X","authenticated-orcid":false,"given":"Yuen\u2010Kwun","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine Queen Mary Hospital Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Ho\u2010Yin","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine Queen Mary Hospital Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuen\u2010Kei","family":"Chiu","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine Queen Mary Hospital Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariane Xia\u2010Wei","family":"Chu","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine Queen Mary Hospital Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7363-0239","authenticated-orcid":false,"given":"William C. Y.","family":"Leung","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine Queen Mary Hospital Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2758-3253","authenticated-orcid":false,"given":"Anderson Chun\u2010On","family":"Tsang","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery Department of Surgery Queen Mary Hospital Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay\u2010Cheong","family":"Teo","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine Queen Mary Hospital Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry Ka\u2010Fung","family":"Mak","sequence":"additional","affiliation":[{"name":"The State Key Laboratory of Brain and Cognitive Sciences University of Hong Kong Hong Kong"},{"name":"Department of Diagnostic Radiology Queen Mary Hospital Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000375"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz455"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1910355"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe1914757"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.020104"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.016694"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437738.63853.7a"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.24.1.35"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108153250701"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043033"},{"key":"e_1_3_2_12_2","first-page":"1012","article-title":"Intracranial vascular stenosis and occlusive disease: evaluation with CT angiography, MR angiography, and digital subtraction angiography","volume":"26","author":"Bash S","year":"2005","unstructured":"Bash S, Villablanca JP, Jahan R, Duckwiler G, Tillis M, Kidwell C, Saver J, Sayre J. 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