Association between non-traditional lipid parameters and futile recanalization in patients with acute ischemic stroke undergoing mechanical thrombectomy

Abstract Background Non-traditional lipid parameters are crucial biomarkers associated with outcomes of acute ischemic stroke (AIS). We aim to explore the relationship between non-traditional lipid parameters and futile recanalization (FR) following mechanical thrombectomy (MT) for acute large arter...

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Main Authors: Jia Duan, Jian Duan, Longyi Zheng, Shuang Tang, Shuang Xie, Wenli Xing, Ao Qian
Format: Article
Language:English
Published: BMC 2025-08-01
Series:European Journal of Medical Research
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Online Access:https://doi.org/10.1186/s40001-025-03059-4
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author Jia Duan
Jian Duan
Longyi Zheng
Shuang Tang
Shuang Xie
Wenli Xing
Ao Qian
author_facet Jia Duan
Jian Duan
Longyi Zheng
Shuang Tang
Shuang Xie
Wenli Xing
Ao Qian
author_sort Jia Duan
collection DOAJ
description Abstract Background Non-traditional lipid parameters are crucial biomarkers associated with outcomes of acute ischemic stroke (AIS). We aim to explore the relationship between non-traditional lipid parameters and futile recanalization (FR) following mechanical thrombectomy (MT) for acute large artery occlusion (LAO). Methods A retrospective study was conducted in our stroke center. The definition of FR is modified Rankin scale (mRS) score ≥ 3 at 90-day follow-up. The non-traditional lipid parameters include atherogenic index of plasma (AIP), apolipoprotein (Apo) B/A1 ratio, Castelli’s risk index (CRI), lipoprotein combine index (LCI), residual lipoprotein cholesterol (RLP-C), and non-high-density lipoprotein cholesterol (non-HDL-C). Multivariate regression analysis was performed to identify independent factors of FR between these parameters, as continuous variables. Then, AIP, Apo B/A1 ratio, CRI-I, and CRI-II, all of which met the significance, were categorized into tertiles to further investigate their relationship with FR through multivariate regression analysis and restricted cubic spline (RCS) curves. Then, linear regression analysis was employed to explore the association between non-traditional lipid parameters and the final infarct volume. Results A total of 338 patients were enrolled into this study, and 196 (56.5%) patients experienced FR. AIP, Apo B/A1 ratio, CRI-I, and CRI-II were categorized into tertiles based on value. Compared with patients in the lowest tertile, those in the highest tertile had significantly increased risk of FR (AIP: odds ration [OR] 2.64, 95% CI 1.27–5.51, P = 0.009; Apo B/A1 ratio: OR 2.21, 95% CI 1.12–4.40, P = 0.023; CRI-I: OR 3.41, 95% CI 1.60–7.31, P = 0.002; CRI-II: OR 3.38, 95% CI 1.58–7.21, P = 0.002). RCS curves demonstrated a linear relationship between those four parameters and FR (all P non-linear > 0.05). Linear regression analysis confirmed that AIP and CRI-II were positively correlated with the final infarct volume (AIP: β 2.61, 95% CI 0.20–5.03, P = 0.034; CRI-II: β 8.93, 95% CI 1.12–16.74, P = 0.025). Conclusion This study provides evidence that AIP, Apo B/A1, CRI-I, and CRI-II are independent risk factors of FR following MT for acute LAO, and can be novel biomarkers of prognosis in patients treated with MT.
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publishDate 2025-08-01
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spelling doaj-art-4ba320e5ef2f4618b8e0f5bb89686fcd2025-08-24T11:15:10ZengBMCEuropean Journal of Medical Research2047-783X2025-08-0130111410.1186/s40001-025-03059-4Association between non-traditional lipid parameters and futile recanalization in patients with acute ischemic stroke undergoing mechanical thrombectomyJia Duan0Jian Duan1Longyi Zheng2Shuang Tang3Shuang Xie4Wenli Xing5Ao Qian6Department of Cerebrovascular Disease, Suining Central HospitalDepartment of Cerebrovascular Disease, Suining Central HospitalDepartment of Radiology, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen UniversityDepartment of Cerebrovascular Disease, Suining Central HospitalDepartment of Cerebrovascular Disease, Suining Central HospitalDepartment of Cerebrovascular Disease, Suining Central HospitalDepartment of Cerebrovascular Disease, Suining Central HospitalAbstract Background Non-traditional lipid parameters are crucial biomarkers associated with outcomes of acute ischemic stroke (AIS). We aim to explore the relationship between non-traditional lipid parameters and futile recanalization (FR) following mechanical thrombectomy (MT) for acute large artery occlusion (LAO). Methods A retrospective study was conducted in our stroke center. The definition of FR is modified Rankin scale (mRS) score ≥ 3 at 90-day follow-up. The non-traditional lipid parameters include atherogenic index of plasma (AIP), apolipoprotein (Apo) B/A1 ratio, Castelli’s risk index (CRI), lipoprotein combine index (LCI), residual lipoprotein cholesterol (RLP-C), and non-high-density lipoprotein cholesterol (non-HDL-C). Multivariate regression analysis was performed to identify independent factors of FR between these parameters, as continuous variables. Then, AIP, Apo B/A1 ratio, CRI-I, and CRI-II, all of which met the significance, were categorized into tertiles to further investigate their relationship with FR through multivariate regression analysis and restricted cubic spline (RCS) curves. Then, linear regression analysis was employed to explore the association between non-traditional lipid parameters and the final infarct volume. Results A total of 338 patients were enrolled into this study, and 196 (56.5%) patients experienced FR. AIP, Apo B/A1 ratio, CRI-I, and CRI-II were categorized into tertiles based on value. Compared with patients in the lowest tertile, those in the highest tertile had significantly increased risk of FR (AIP: odds ration [OR] 2.64, 95% CI 1.27–5.51, P = 0.009; Apo B/A1 ratio: OR 2.21, 95% CI 1.12–4.40, P = 0.023; CRI-I: OR 3.41, 95% CI 1.60–7.31, P = 0.002; CRI-II: OR 3.38, 95% CI 1.58–7.21, P = 0.002). RCS curves demonstrated a linear relationship between those four parameters and FR (all P non-linear > 0.05). Linear regression analysis confirmed that AIP and CRI-II were positively correlated with the final infarct volume (AIP: β 2.61, 95% CI 0.20–5.03, P = 0.034; CRI-II: β 8.93, 95% CI 1.12–16.74, P = 0.025). Conclusion This study provides evidence that AIP, Apo B/A1, CRI-I, and CRI-II are independent risk factors of FR following MT for acute LAO, and can be novel biomarkers of prognosis in patients treated with MT.https://doi.org/10.1186/s40001-025-03059-4LipidAcute ischemic strokeLarge artery occlusionMechanical thrombectomyFutile recanalization
spellingShingle Jia Duan
Jian Duan
Longyi Zheng
Shuang Tang
Shuang Xie
Wenli Xing
Ao Qian
Association between non-traditional lipid parameters and futile recanalization in patients with acute ischemic stroke undergoing mechanical thrombectomy
European Journal of Medical Research
Lipid
Acute ischemic stroke
Large artery occlusion
Mechanical thrombectomy
Futile recanalization
title Association between non-traditional lipid parameters and futile recanalization in patients with acute ischemic stroke undergoing mechanical thrombectomy
title_full Association between non-traditional lipid parameters and futile recanalization in patients with acute ischemic stroke undergoing mechanical thrombectomy
title_fullStr Association between non-traditional lipid parameters and futile recanalization in patients with acute ischemic stroke undergoing mechanical thrombectomy
title_full_unstemmed Association between non-traditional lipid parameters and futile recanalization in patients with acute ischemic stroke undergoing mechanical thrombectomy
title_short Association between non-traditional lipid parameters and futile recanalization in patients with acute ischemic stroke undergoing mechanical thrombectomy
title_sort association between non traditional lipid parameters and futile recanalization in patients with acute ischemic stroke undergoing mechanical thrombectomy
topic Lipid
Acute ischemic stroke
Large artery occlusion
Mechanical thrombectomy
Futile recanalization
url https://doi.org/10.1186/s40001-025-03059-4
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