The joint association of lipoprotein(a) and lipoprotein-associated phopholipase A2 with the risk of stroke recurrence

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology Pub Date : 2024-09-01 DOI:10.1016/j.jacl.2024.04.133

Jing Xue MD, PhD , Yukun Xiang MD , Xue Jiang PhD , Aoming Jin PhD , Xiwa Hao MD, PhD , Ke Li MD , Jinxi Lin PhD , Xia Meng MD, PhD , Hao Li PhD , Lemin Zheng PhD , Yongjun Wang MD, PhD , Jie Xu MD, PhD

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引用次数: 0

Abstract

BACKGROUND AND PURPOSE

Currently little is known about the joint association of lipoprotein (a) [Lp(a)] and lipoprotein-associated phospholipase A2 (Lp-PLA2) with stroke recurrence.

METHODS

In this prospective multicenter cohort study, 10,675 consecutive acute ischemic stroke (IS) and transient ischemic attack (TIA) patients with Lp(a) and Lp-PLA2 were enrolled. The association of stroke recurrence within 1 year with Lp(a) and Lp-PLA2 was assessed using Cox proportional hazards models and Kaplan-Meier curves. The interaction between Lp(a) and Lp-PLA2 with stroke recurrence was evaluated by multiplicative and additive scales.

RESULTS

A significant joint association of Lp(a) and Lp-PLA2 with the risk of stroke recurrence was observed. Multivariate Cox regression analysis demonstrated that the combination of elevated Lp(a) (≥ 50 mg/dL) and Lp-PLA2 (≥175.1 ng/mL) was independently associated with the risk of stroke recurrence (adjusted hazard ratio: 1.42; 95% confidence interval [CI]: 1.15–1.76). Both significant multiplicative [(exp(β3): 1.63, 95% CI: 1.17–2.29, P = 0.004] and additive interaction (RERI: 0.55, 95% CI: 0.20–0.90, P = 0.002; AP: 0.39, 95% CI, 0.24–0.53) were observed between Lp(a) and Lp-PLA2.

CONCLUSIONS

Our results indicated that Lp(a) and Lp-PLA2 have a joint association with the risk of stroke recurrence in IS/TIA patients. Patients with concomitant presence of elevated Lp(a) and Lp-PLA2 have greater risk of stroke recurrence.

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脂蛋白（a）和脂蛋白-PLA2 与中风复发风险的共同关系

在这项前瞻性多中心队列研究中，共纳入了 10,675 名伴有脂蛋白（a）和脂蛋白磷脂酶 A2（Lp-PLA2）的连续急性缺血性卒中（IS）和短暂性脑缺血发作（TIA）患者。使用 Cox 比例危险模型和 Kaplan-Meier 曲线评估了 1 年内中风复发与 Lp(a) 和 Lp-PLA2 的关系。结果观察到 Lp(a) 和 Lp-PLA2 与中风复发风险有显著的联合关系。多变量 Cox 回归分析表明，Lp(a) 升高（≥ 50 mg/dL）和 Lp-PLA2 升高（≥ 175.1 ng/mL）与中风复发风险独立相关（调整后危险比：1.42；95% 置信区间 [CI]：1.15-1.76）。在 Lp(β3)和 Lp(β4)之间观察到明显的乘法[（exp(β3)：1.63，95% CI：1.17-2.29，P = 0.004]和加法交互作用（RERI：0.55，95% CI：0.20-0.90，P = 0.002；AP：0.39，95% CI，0.24-0.53）。结论我们的研究结果表明，Lp（a）和 Lp-PLA2 与 IS/TIA 患者的卒中复发风险有关联。同时存在 Lp(a) 和 Lp-PLA2 升高的患者中风复发的风险更大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of clinical lipidology 医学-药学

CiteScore

7.00

自引率

6.80%

发文量

209

审稿时长

49 days

期刊介绍： Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.