Research Questions:
1. Are baseline levels of remnant cholesterol (RC) and other lipid indicators associated with the risk of developing post-stroke cognitive impairment (PSCI) or post-stroke depression (PSD)?
2. Does long-term variability (fluctuation) in these lipid levels influence the risk of these neuropsychiatric sequelae?
3. Does a specific lipid profile of high RC coupled with low LDL-C confer a different risk compared to other profiles, such as high LDL-C with low RC?
Aims:
1. To describe the baseline lipid profile characteristics in a stroke patient cohort within the UK Biobank.
2. To exploratorily analyze the associations between baseline lipid levels and the risk of PSCI or PSD.
3. To investigate the impact of long-term lipid variability on these outcomes.
4. To specifically examine the effect of the discordance between RC and LDL-C on the risk of post-stroke neuropsychiatric sequelae.
Scientific Rationale:
Post-stroke cognitive impairment and depression are devastating complications that significantly impair recovery and quality of life. While lipid management is well-established for primary stroke prevention, its role in predicting long-term neuropsychiatric outcomes after a stroke is unclear. Remnant cholesterol (RC) is an emerging and highly atherogenic lipid particle. However, large-scale evidence linking RC, particularly its dynamics and its relationship with LDL-C, to PSCI or PSD is lacking. This project aims to fill this critical knowledge gap by leveraging the UK Biobank’s large prospective cohort to determine if RC offers novel predictive value for these important post-stroke conditions, potentially informing future prevention strategies.
