Lipoprotein (a) Concentration is Inversely Related with Vertebral Arterial Flow

Abstract

Objectives: Posterior circulation ischemia syndrome is a common feature of the poor blood flow to the posterior cerebral regions which is generally caused by atherosclerotic involvement of vertebral arteries (VA). However, the risk factors for VA atherosclerosis remain largely unknown. Lipoprotein (a) (Lp(a)), a modified low-density lipoprotein, has been implicated as a risk factor for coronary and peripheral artery disease. Our aim was to investigate the possible association of Lp(a) with low vertebral artery flow, a marker representing VA atherosclerosis. Methods: An institutional registry database was used for the present study. A complete dataset, including Doppler ultrasound imaging of the carotid and VA was available in 135 of 718 cases, and these cases were included in the analysis. Results: 29 (21.1%) patients had Lp(a)>30 mg/dL, and total VA flow in these patients was significantly less than in patients with Lp(a)<30 mg/dL (243.0 mL/min [212.0–276.0] vs. 256.0 mL/min [230.0–307.0], p=0.03). Lp(a) had a significant correlation with VA flow (r=−0.24, p=0.004), and this association remained significant after adjustment for other lipid parameters (β=−0.244, p=0.004) and demographic variables (β=−0.225, p=0.007). Furthermore, the correlation between Lp(a) and VA flow was stronger in 11 patients with evidence of carotid atherosclerosis on DUS (r=−0.74, p<0.001). Conclusion: