Abstract
BackgroundThe association of lipoprotein(a) [Lp(a)] and stroke functional outcomes was conflicting. The aim of the study was to clarify whether high Lp(a) is associated with unfavorable functional outcomes in patients with ischemic stroke.MethodsA total of 9709 individuals from the third China National Stroke Registry cohort were recruited. Plasma level of Lp(a) at admission was measured with enzyme-linked immunosorbent assay. The cut-off was set at the median for Lp(a). Functional outcome was assessed using the modified Rankin scale (mRS) at 3 months and 1 year after ischemic stroke. The association between Lp(a) and functional outcomes was evaluated using a logistic regression model.ResultsThe median age was 63.0 years, and 31.1% participants were women. Patients in higher Lp(a) group had higher incidences of unfavorable functional outcomes at 3 months. In logistic regression model, elevated Lp(a) levels were associated with unfavorable functional outcomes at 3 months (Q4 vs. Q1: odds ratio 1.33, 95% confidence interval 1.11–1.61). Subgroup analysis showed that in the lower Lp-PLA2 group, Lp(a) level was not associated with functional outcomes, but in the higher Lp-PLA2 group, Lp(a) level was significantly associated with functional outcomes. After grouped by different levels of Lp(a) and Lp-PLA2, the Lp(a) high/ Lp-PLA2 high group showed the highest incidence of unfavorable functional outcomes at 3 months and 1 year.ConclusionsElevated Lp(a) level is associated with unfavorable functional outcomes in patients with ischemic stroke. The increment in both Lp(a) and Lp-PLA2 are associated with unfavorable functional outcomes at 3 months and 1 year after ischemic stroke.
Highlights
The association of lipoprotein(a) [Lp(a)] and stroke functional outcomes was conflicting
We aimed to evaluate the hypothesis that a high level of Lp(a) is associated with unfavorable functional outcomes and Lp(a) high/Lp-PLA2 high have a significant association with unfavorable functional outcomes in patients with ischemic stroke from the third China National Stroke Registry (CNSR-III) database
A total of 10,491 ischemic stroke patients’ blood samples were collected and examined at the laboratory, of which 664 patients lack of Lp(a) data and 118 patients lack of functional outcomes were excluded, and a total of 9709 patients were included in the study (Additional file 1: Figure S1)
Summary
The association of lipoprotein(a) [Lp(a)] and stroke functional outcomes was conflicting. The aim of the study was to clarify whether high Lp(a) is associated with unfavorable functional outcomes in patients with ischemic stroke. The pro-inflammatory of Lp(a) is partially mediated by oxidized phospholipids attached to apo(a) [1]. Inflammation is involved in the occurrence and development of unfavorable functional outcomes in patients with ischemic stroke [7]. Lipoprotein-associated phospholipase A2 [Lp-PLA2], an inflammatory marker, is an independent predictor of ischemic stroke and coronary heart disease [8, 9]. Previous studies examined the association of Lp(a) with risk of unfavorable functional outcomes in patients with ischemic stroke [11,12,13], rare studies have conducted the association of Lp(a) and Lp-PLA2 levels to stroke functional outcomes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
