Elevated lipoprotein(a) and lipoprotein-associated phospholipase A2 are associated with unfavorable functional outcomes in patients with ischemic stroke

• Published in: Journal of neuroinflammation 2021-12, Vol.18 (1), p.1-307, Article 307
• Main Authors: Jiang, Xue, Xu, Jie, Hao, Xiwa, Xue, Jing, Li, Ke, Jin, Aoming, Lin, Jinxi, Meng, Xia, Zheng, Lemin, Wang, Yongjun
• Format: Article
• Language: English
• Subjects: Apolipoproteins; Atherosclerosis; Body mass index; Cardiovascular disease; Diabetes; Drugs; Enzyme-linked immunosorbent assay; Functional outcomes; Health aspects; High density lipoprotein; Inflammation; Ischemia; Ischemic stroke; Laboratories; Lipoprotein A; Lipoprotein-associated phospholipase A2; Lipoproteins; Patient outcomes; Phospholipase A2; Plasma; Risk factors; Sensitivity analysis; Stroke; Stroke (Disease); Transient ischemic attack
• ISSN: 1742-2094; 1742-2094
• DOI: 10.1186/s12974-021-02359-w

Background 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. Methods A 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. Results The 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-PLA.sub.2 group, Lp(a) level was not associated with functional outcomes, but in the higher Lp-PLA.sub.2 group, Lp(a) level was significantly associated with functional outcomes. After grouped by different levels of Lp(a) and Lp-PLA.sub.2, the Lp(a) high/ Lp-PLA.sub.2 high group showed the highest incidence of unfavorable functional outcomes at 3 months and 1 year. Conclusions Elevated Lp(a) level is associated with unfavorable functional outcomes in patients with ischemic stroke. The increment in both Lp(a) and Lp-PLA.sub.2 are associated with unfavorable functional outcomes at 3 months and 1 year after ischemic stroke. Keywords: Lipoprotein(a), Lipoprotein-associated phospholipase A.sub.2, Inflammation, Functional outcomes, Ischemic stroke