Abstract W P160: Elevated Lipoprotein A Levels Predict Worse Short-term Outcomes in Acute Ischemic Stroke
Background: Lipoprotein A (Lp(a)) is a risk factor for vascular disease; however, few studies have examined the relationship between serum levels of Lp(a) and patient outcomes in acute ischemic stroke (AIS). In this study, we sought to assess whether AIS patients with elevated Lp(a) levels exhibit characteristic differences in stroke severity, in-hospital complications, and short-term outcomes as compared to patients with normal Lp(a) levels.
Methods: From our prospective stroke registry, patients consecutively admitted and diagnosed with AIS 07/2008-10/2013 were included if Lp(a) levels were measured during admission. Regressions, adjusting for key covariates, analyzed outcomes in patients with elevated (+) and severely elevated (++) Lp(a) with respect to normal (-) Lp(a). The primary outcome was poor functional outcome (modified Rankin Scale > 2) on discharge.
Results: Among the 1,453 patients in our stroke registry, 159 patients met our inclusion criteria; 24 patients (15.1%) were in the +Lp(a) group and 37 patients (23.3%) in the ++Lp(a) group. After adjustment for total cholesterol, LDL, HDL, and triglycerides, patients with ++Lp(a) were more than twice as likely to experience poor functional outcome (OR=2.48, 95% CI 1.0781-5.7231, p=0.033) as those with -Lp(a). Adjusting for age, NIHSS baseline, history of diabetes, admission glucose level, and tPA administration, patients with ++Lp(a) were more than 2.5 times more likely to experience poor functional outcome (OR=2.59, 95% CI 1.0129-6.6282, p=0.047) as compared to those with -Lp(a).
Conclusions: Lp(a) elevation predicts higher odds of poor functional outcomes for patients with AIS compared to patients with normal levels. Our findings support the utility of Lp(a) level as a clinically useful biomarker in the development of patient risk profiles.
Author Disclosures: A.A. Samai: None. D.J. Monlezun: None. A. Shaban: None. A. George: None. J. Cyprich: None. R. El Khoury: None. S. Martin-Schild: None.
- © 2015 by American Heart Association, Inc.