Remnant Cholesterol and Carotid Intraplaque Neovascularization Assessed by Contrast-Enhanced Ultrasonography in Patients With Ischemic Stroke

Background: We investigated the relationship between remnant cholesterol and carotid intraplaque neovascularization (IPN) assessed by contrast -enhanced ultrasonography (CEUS) in patients with ischemic stroke. Methods: This was a single -center study. Remnant cholesterol is calculated as total cholesterol minus low -density lipoprotein cholesterol (LDL-C) minus high -density lipoprotein cholesterol (HDL-C). All patients underwent CEUS. IPN is graded according to the presence and location of microbubbles within each plaque. Results: The cohort included 110 patients with ischemic stroke. Patients with an IPN grading of 2 had higher triglyceride (TG), nonHDL-C, and remnant cholesterol concentrations than those with an IPN grading of < 2 (TG: 1.45 +/- 0.69 vs. 0.96 +/- 0.24 mmol/L, P < 0.001; non-HDL-C: 2.63 +/- 0.85 vs. 2.31 +/- 0.64 mmol/L, P = 0.037; remnant cholesterol: 0.57 +/- 0.23 vs. 0.44 +/- 0.07 mmol/L, P < 0.001). The multivariate -adjusted odds ratio (95% confidence interval) for remnant cholesterol was 27.728 (2.714 - 283.253) for an IPN grading of 2 in the subset of patients with an optimal LDL-C concentration. Conclusions: The remnant cholesterol concentration is significantly associated with carotid IPN on CEUS in patients with ischemic stroke with an optimal LDL-C concentration. Remnant cholesterol may be an important indicator of risk stratification in patients with ischemic stroke.