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(Stroke. 2000;31:1194-a.)
© 2000 American Heart Association, Inc.

Letters to the Editor

Lipoprotein(a) and the Risk of Stroke

Robert J. Wityk, MD

Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland

Steven Kittner, MD

Department of Neurology, and Department of Epidemiology and Preventive Medicine, University of Maryland at Baltimore, Geriatrics Research, Education, and Clinical Center, Baltimore Department of Veterans Affairs Medical Center, Baltimore, Maryland

Key Words: lipoproteins • risk factors • case-control studies

To the Editor:

Despite a number case-control studies in the literature suggesting that lipoprotein(a) is a risk factor for cerebrovascular disease, both the recent article by Glader et al¹ and the report from the Physicians Health Study by Ridker et al² failed to demonstrate an association of lipoprotein(a) and the future risk of stroke. One possible explanation discussed by Glader et al is the paucity of young stroke patients in their study population. Nagayama et al³ had previously reported significantly higher lipoprotein(a) levels in patients under age 45 years with atherosclerotic stroke. In the Stroke Prevention in Young Women Study, we⁴ examined the role of lipoprotein(a) in a population-based study of women under the age of 45 years with ischemic stroke. In both univariate and multivariate analyses, we found no significant difference in lipoprotein(a) levels between cases and age-matched controls. Even among the subset of patients with atherosclerotic stroke, we could not demonstrate an association with elevated lipoprotein(a) levels. The number of patients in our study with atherosclerotic stroke was small (n=15), however, but comparable to that of Nagayama et al (n=11).

The structure of lipoprotein(a) and its potential link to both atherosclerosis and hypercoagulability is an intriguing hypothesis, but at this time the epidemiologic basis for a relationship of lipoprotein(a) and stroke remains uncertain.

References

1. Glader CA, Stegmayr B, Boman J, Stenlund H, Weinehall L, Hallmans G, Dahlen GH. Chlamydia pneumoniae antibodies and high lipoprotein(a) levels do not predict ischemic cerebral infarctions. Stroke.. 1999;30:2013–2018.[Abstract/Free Full Text]

2. Ridker PM, Stampfer MJ, Hennekens CH. Plasma concentration of lipoprotein(a) and the risk of future stroke. JAMA.. 1995;273:1269–1273.[Abstract/Free Full Text]

3. Nagayama M, Shinohara Y, Nagayama T. Lipoprotein(a) and ischemic cerebrovascular disease in young adults. Stroke.. 1994;25:74–78.[Abstract]

4. Wityk RJ, Kittner SJ, Jenner JL, Hebel JR, Epstein A, Wozniak AM, Stolley PD, Stern BJ, Sloan MA, Price TR, McCarter RJ, Macko RF, Johnson CJ, Earley CJ, Buchholz D, Schaefer EJ. Lipoprotein(a) and the risk of ischemic stroke in young women. Atherosclerosis. In press.

This Article Extract Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wityk, R. J. Articles by Kittner, S. Search for Related Content PubMed Articles by Wityk, R. J. Articles by Kittner, S. Related Collections Acute Cerebral Infarction Brain Circulation and Metabolism Doppler ultrasound, Transcranial Doppler etc.