Impact of elevated lipoprotein(a) levels on the functional outcomes of ischemic stroke patients: A systematic review and meta-analysis

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

European Journal of Neurology Pub Date : 2024-10-01 DOI:10.1111/ene.16501

Huarong Liu, Bo Li, Ting Lu, Chong Chen, Xi Xiong, Xing Li, Rengui Yang

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Abstract

Background and purpose

Elevated serum lipoprotein(a) (Lp[a]) levels have been linked to an increased incidence of stroke. This systematic review and meta-analysis aimed to evaluate the impact of serum Lp(a) on the functional outcomes of patients with ischemic stroke (IS).

Methods

We conducted a comprehensive search of the MEDLINE, Web of Science, Embase, Wanfang, and China National Knowledge Infrastructure databases to identify relevant cohort studies. A random effects model was utilized to synthesize the data, accounting for study heterogeneity.

Results

The analysis included 11 cohort studies comprising 11,958 patients with IS. Pooled results indicated that high baseline Lp(a) levels were associated with an increased risk of poor functional outcomes during follow-up (odds ratio [OR] = 2.13, 95% confidence interval = 1.67–2.71, p < 0.001, I² = 62%). Subgroup analyses revealed that the relationship between high Lp(a) levels and the risk of poor functional outcomes was more pronounced at discharge (OR = 3.25), 3 months (OR = 2.02), and 6 months (OR = 2.11) poststroke, compared to 12 months (OR = 1.25, p for subgroup difference < 0.001). Furthermore, the association was attenuated yet remained significant in studies adjusting for low-density lipoprotein cholesterol (LDL-C) compared to those that did not adjust for LDL-C (OR = 1.69 vs. 2.63, p for subgroup difference = 0.03).

Conclusions

High serum Lp(a) levels at baseline are significantly associated with poor functional outcomes in patients with IS.

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脂蛋白（a）水平升高对缺血性脑卒中患者功能预后的影响：系统回顾和荟萃分析。

背景和目的：血清脂蛋白（a）（Lp[a]）水平升高与中风发病率增加有关。本系统综述和荟萃分析旨在评估血清脂蛋白（a）对缺血性卒中（IS）患者功能预后的影响：我们对 MEDLINE、Web of Science、Embase、万方和中国国家知识基础设施数据库进行了全面检索，以确定相关的队列研究。考虑到研究的异质性，我们采用随机效应模型对数据进行了综合分析：结果：分析纳入了 11 项队列研究，包括 11958 名 IS 患者。汇总结果显示，基线脂蛋白（a）水平高与随访期间功能预后差的风险增加有关（几率比 [OR] = 2.13，95% 置信区间 = 1.67-2.71，P 2 = 62%）。亚组分析表明，与卒中后12个月相比（OR = 1.25，P为亚组差异），卒中后出院（OR = 3.25）、3个月（OR = 2.02）和6个月（OR = 2.11）时高脂蛋白（a）水平与不良功能预后风险之间的关系更为明显：基线血清脂蛋白（a）水平高与IS患者功能预后差密切相关。

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

European Journal of Neurology 医学-临床神经学

CiteScore

9.70

自引率

2.00%

发文量

418

审稿时长

1 months

期刊介绍： The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).