The joint association of lipoprotein(a) and lipoprotein-associated phopholipase A2 with the risk of stroke recurrence.

Journal: Journal Of Clinical Lipidology
Published:
Abstract

Objective: Currently little is known about the joint association of lipoprotein (a) [Lp(a)] and lipoprotein-associated phospholipase A2 (Lp-PLA2) with stroke recurrence.

Methods: In this prospective multicenter cohort study, 10,675 consecutive acute ischemic stroke (IS) and transient ischemic attack (TIA) patients with Lp(a) and Lp-PLA2 were enrolled. The association of stroke recurrence within 1 year with Lp(a) and Lp-PLA2 was assessed using Cox proportional hazards models and Kaplan-Meier curves. The interaction between Lp(a) and Lp-PLA2 with stroke recurrence was evaluated by multiplicative and additive scales.

Results: A significant joint association of Lp(a) and Lp-PLA2 with the risk of stroke recurrence was observed. Multivariate Cox regression analysis demonstrated that the combination of elevated Lp(a) (≥ 50 mg/dL) and Lp-PLA2 (≥175.1 ng/mL) was independently associated with the risk of stroke recurrence (adjusted hazard ratio: 1.42; 95% confidence interval [CI]: 1.15-1.76). Both significant multiplicative [(exp(β3): 1.63, 95% CI: 1.17-2.29, P = 0.004] and additive interaction (RERI: 0.55, 95% CI: 0.20-0.90, P = 0.002; AP: 0.39, 95% CI, 0.24-0.53) were observed between Lp(a) and Lp-PLA2.

Conclusions: Our results indicated that Lp(a) and Lp-PLA2 have a joint association with the risk of stroke recurrence in IS/TIA patients. Patients with concomitant presence of elevated Lp(a) and Lp-PLA2 have greater risk of stroke recurrence.

Authors
Jing Xue, Yukun Xiang, Xue Jiang, Aoming Jin, Xiwa Hao, Ke Li, Jinxi Lin, Xia Meng, Hao Li, Lemin Zheng, Yongjun Wang, Jie Xu