Elevated serum lipoprotein(a) as a potential predictor for combined intracranial and extracranial artery stenosis in patients with ischemic stroke
| Autor: | Oh Young Bang, B.S. Kim, Gyeong-Moon Kim, Chin-Sang Chung, H.S. Jung, Kwang Hyuck Lee |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Constriction Pathologic Brain ischemia Ischemia Risk Factors Internal medicine medicine Humans Carotid Stenosis Prospective Studies Risk factor Stroke Aged biology Vascular disease business.industry Cerebral infarction Angiography Lipoprotein(a) Middle Aged Intracranial Arteriosclerosis medicine.disease Magnetic Resonance Imaging Surgery Stenosis medicine.anatomical_structure biology.protein Cardiology Female Cardiology and Cardiovascular Medicine business Magnetic Resonance Angiography Artery |
| Zdroj: | Atherosclerosis. 212:682-688 |
| ISSN: | 0021-9150 |
| Popis: | Objectives: Despite compelling evidence of lipoprotein(a) [Lp(a)] as a risk factor for ischemic stroke, its underlying mechanism remains unclear. Our aim is to investigate whether serum Lp(a) level is associated with the extent and location of cerebral steno-occlusive lesions, and with large artery atherosclerotic (LAA) stroke in Korean patients. Methods: We analyzed data prospectively collected over a 3-year period on consecutive patients with stroke or TIA. Based on an angiographic study, a total of 1012 patients were classified into four subtypes: non-cerebral stenosis (n = 654), intracranial stenosis (n = 198), extracranial carotid stenosis (n = 86), and combined intracranial and extracranial carotid stenosis (n = 74). Independent associations of Lp(a) levels with the extent and location of cerebral stenosis were evaluated, and Lp(a) levels of subtypes by the TOAST criteria were compared. Results: Lp(a) levels of LAA stroke were significantly higher than those of the other four stroke mechanisms. Patients with more advanced intracranial (p = 0.001) and extracranial carotid stenoses (p = 0.001) tended to have higher Lp(a) levels. In multiple regression analysis, the third Lp(a) quartile was the strongest risk factor for isolated intracranial (OR 3.36, 95% CI 1.77–6.37) or extracranial stenosis (OR 4.82, 95% CI 1.96–11.88), whereas the fourth Lp(a) quartile was the most powerful predictor for combined intracranial and extracranial carotid stenosis (OR 4.98, 95% CI 1.92–12.91). Conclusions: Our results indicate that greatly elevated Lp(a) levels are associated with LAA stroke and extensive burden of cervicocerebral steno-occlusive lesions, which might offer indirect evidence of |
| Databáze: | OpenAIRE |
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