Association of Lipoprotein-Associated Phospholipase A2 and Lipoprotein(a) With the Risk of Recurrence Stroke in Patients With Acute Ischemic Stroke

Abstract

Objective: It is still a major global challenge to reduce the high morbidity and mortality of acute ischemic stroke (AIS) and improve the prognosis of patients. This study aims to investigate the prognostic value of lipoprotein-associated phospholipase A2 (Lp-PLA2) combined with lipoprotein(a) (Lp(a)) for long-term stroke recurrence in patients with AIS. Methods: This study included 580 patients with AIS. Assessment of Lp-PLA2 and Lp(a) levels was conducted upon patient admission. Continuous monitoring over the long term categorized stroke recurrence as an endpoint. Patients were categorized based on these identified thresholds to compare the risk of stroke recurrence: high Lp-PLA2 and high Lp(a), high Lp-PLA2 and low Lp(a), low Lp-PLA2 and high Lp(a), and low Lp-PLA2 combined with low Lp(a). Results: Among the 580 participants, 101 individuals (17.41%) experienced stroke recurrence within the 2-year follow-up. The majority were male (61.39%), with a median age of 62 years (interquartile range: 55–69.5). Factors independently associated with heightened the risk of recurrence stroke comprised age (hazard ratio [HR], 1.025; p = 0.021), diabetes mellitus (HR, 1.751; p = 0.007), Lp-PLA2 (HR, 1.004; p < 0.001), and Lp(a) (HR, 1.002; p < 0.001). Noteworthy is that the combination of Lp-PLA2 and Lp(a) displayed superior predictive efficacy for long-term stroke recurrence risk in AIS patients compared to individual factors. Conclusion: This investigation underscores the potential advantage of leveraging the combined impact of Lp-PLA2 in conjunction with Lp(a) as a more precise and cost-effective predictive tool for the risk of recurrence stroke in patients with AIS.