Association of elevated lipoprotein(a) levels with ischemic stroke in young patients - a systematic review and meta-analysis.

Autor: Koh MY; Ministry of Health Holdings, Singapore., Toh KZ; Ministry of Health Holdings, Singapore., Loh ED; Ministry of Health Holdings, Singapore., Teo YN; Ministry of Health Holdings, Singapore., Joon KC; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Tan QX; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Sharma VK; Division of Neurology, Department of Medicine, National University Hospital, Singapore., Yeo LL; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurology, Department of Medicine, National University Hospital, Singapore., Sia CH; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre, Singapore., Loh WJ; Department of Endocrinology, Changi General Hospital, Singapore., Tan BY; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurology, Department of Medicine, National University Hospital, Singapore. Electronic address: benjaminyqtan@gmail.com.
Jazyk: angličtina
Zdroj: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2024 Nov; Vol. 33 (11), pp. 107960. Date of Electronic Publication: 2024 Aug 31.
DOI: 10.1016/j.jstrokecerebrovasdis.2024.107960
Abstrakt: Introduction: Lipoprotein(a) [Lp(a)] is an established independent causal risk factor for cardiovascular disease and atherosclerosis. However, its association with young-onset ischemic stroke is not well-established. A systematic review and meta-analysis was performed to investigate the association of elevated Lp(a) with young ischemic stroke.
Methods: Four electronic databases: PubMed (MEDLINE), EMBASE, Scopus and Cochrane Library were systematically searched, profiling studies from inception till 6 Mar 2024. We included studies investigating the relationship between stratified Lp(a) levels and young ischemic stroke. We compared the odds of young stroke patients (age <65 years) having elevated Lp(a) compared to age-matched controls without stroke or transient ischemic attack.
Results: Five case-control studies comprising a total of 1345 patients were included; 57.7 % (776/1345) were females, with a mean age of 41.5 years. Among them, 22.5 % (264/1171) were smokers. Additionally, 16.8 % (197/1171) had hypertension, 5.9 % (69/1171) had diabetes, and 29.2 % (284/971) had hyperlipidemia. Young stroke patients were more likely to have high Lp(a) level than age-matched controls (OR 1.61, 95 %CI 1.24-2.10). Four studies defined a high Lp(a) level as ≥30mg/dL, whilst one study used a Lp(a) level of >23.2mg/dL as the cut-off. A sensitivity analysis excluding this study showed that young stroke patients were still more likely to have Lp(a) ≥30mg/dL than controls (OR 1.43, 95 %CI 1.08-1.88).
Conclusion: Young stroke patients are more likely to have elevated Lp(a) compared to age-matched controls, suggesting an association between elevated Lp(a) and young stroke. Further research is warranted to evaluate the causal relationships between Lp(a) and young-onset ischemic stroke, as well as to conduct a cost-benefit analysis of Lp(a) screening in young adults as part of a primary prevention strategy.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: 1. Dr Benjamin Tan has received research funding from Abbott and the National Medical Research Council, Singapore, and both fundings are unrelated to this study. 2. Dr Wann Jia Loh has received honoraria from Medtronic, Abbott, DKSH, Novartis,Roche and Amgen for giving talks.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: