Remnant lipoprotein and lipoprotein (a) as risk factors for stroke and carotid disease

Abstract

Remnant lipoprotein (RLP) and lipoprotein (Lp) (a) are known to promote atherosclerosis and thrombosis. We studied whether these lipoproteins can be risk factors for stroke and carotid disease in 170 consecutive subjects (87 males and 83 females, mean age of 70 years). RLP was significantly higher in patients with ( N=45) than without ( N=125) ischemic stroke (Mann–Whitney's U-test, p=0.01), while there was no difference in Lp (a) between patients with and without it ( p=0.83). In contrast, there was a significant difference in Lp (a) ( p=0.003) but not in RLP ( p=0.26) between patients with ( N=76) and without ( N=94) maximum intima-media thickness (IMT) of 2.0 mm or more at carotid bifurcations. Logistic regression analysis showed that RLP is an independent risk factor for ischemic stroke [7.5 mg/dl or more, relative risk (RR) 2.84, 95% confidence interval (CI) 1.26–6.40]. Multivariate regression analysis showed that Lp (a) ( p=0.032) but not RLP ( p=0.518) is significantly correlated with IMT. The results indicate that RLP but not Lp (a) is an independent risk factor for ischemic stroke, while Lp (a) but not RLP is an independent risk factor for carotid disease in our Japanese subjects.