Abstract | BACKGROUND: METHODS: This prospective cohort study included 9899 patients with ischemic stroke or transient ischemic attack from the Third China National Stroke Registry who had measurements of plasma Lp(a) and were followed up for 1 year. Cutoffs were set at the 50 mg/dL for Lp(a). LDL-C was corrected for Lp(a)-derived cholesterol (LDL-Cc [ LDL-C corrected]) and cutoffs were set at 55 and 70 mg/dL.The threshold values of IL-6 ( interleukin 6) and hsCRP (high-sensitive C-reactive protein) were the median 2.65 ng/L and 2 mg/L. Multivariable-adjusted hazard ratio (HR) were calculated using Cox regression models for each category to investigate the associations of Lp(a) with stroke recurrence within 1 year. RESULTS: Among all patients, those with Lp(a) ≥50 mg/dL were at higher stroke recurrence risk than those with Lp(a) <50 mg/dL (11.5% versus 9.4%; adjusted HR, 1.20 [95% CI, 1.02-1.42]). However, the risk associated with elevated Lp(a) was attenuated in patients with LDL-Cc <55 mg/dL (high Lp(a) versus low Lp(a): 8.9% versus 9.0%; adjusted HR, 0.92 [95% CI, 0.65-1.30]) or IL-6 <2.65 ng/L (9.0% versus 7.8%; adjusted HR, 1.14 [95% CI, 0.87-1.49]). Notably, in the group with both low LDL-Cc and inflammation levels, the rate of patients with high Lp(a) did not significantly different from the rate of patients with low Lp(a; LDL-Cc <55 mg/dL and IL-6 <2.65 ng/L: 6.2% versus 7.1%; adjusted HR, 0.86 [95% CI, 0.46-1.62]; LDL-Cc <55 mg/dL and hsCRP <2 mg/L: 7.7% versus 7.6%; adjusted HR, 0.97 [95% CI, 0.57-1.66]). However, there was no interaction between the LDL-Cc, IL-6, hsCRP, and Lp(a) levels on stroke recurrence risk. CONCLUSIONS:
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Authors | Jie Xu, Xiwa Hao, Rui Zhan, Xue Jiang, Aoming Jin, Jing Xue, Aichun Cheng, Jiewen Liu, Jinxi Lin, Xia Meng, Hao Li, Lemin Zheng, Yongjun Wang |
Journal | Stroke
(Stroke)
Vol. 53
Issue 8
Pg. 2504-2511
(08 2022)
ISSN: 1524-4628 [Electronic] United States |
PMID | 35410491
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers
- Cholesterol, LDL
- Interleukin-6
- Lipoprotein(a)
- C-Reactive Protein
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Topics |
- Biomarkers
- C-Reactive Protein
- Cholesterol, LDL
- Humans
- Inflammation
- Interleukin-6
- Ischemic Attack, Transient
(complications)
- Ischemic Stroke
- Lipoprotein(a)
- Prospective Studies
- Risk Factors
- Stroke
(complications)
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