Association of Lipoprotein-Associated Phospholipase A2 and Lipoprotein(a) With the Risk of Recurrence Stroke in Patients With Acute Ischemic Stroke

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis Pub Date : 2024-12-03 DOI:10.1002/jcla.25120

Yu Feng, Shenyang Zhang, Hailiang Li, Hao Li, Ruiguo Dong, Shiguang Zhu, Yanlong Zhou

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Abstract

Objective

It is still a major global challenge to reduce the high morbidity and mortality of acute ischemic stroke (AIS) and improve the prognosis of patients. This study aims to investigate the prognostic value of lipoprotein-associated phospholipase A2 (Lp-PLA2) combined with lipoprotein(a) (Lp(a)) for long-term stroke recurrence in patients with AIS.

Methods

This study included 580 patients with AIS. Assessment of Lp-PLA2 and Lp(a) levels was conducted upon patient admission. Continuous monitoring over the long term categorized stroke recurrence as an endpoint. Patients were categorized based on these identified thresholds to compare the risk of stroke recurrence: high Lp-PLA2 and high Lp(a), high Lp-PLA2 and low Lp(a), low Lp-PLA2 and high Lp(a), and low Lp-PLA2 combined with low Lp(a).

Results

Among the 580 participants, 101 individuals (17.41%) experienced stroke recurrence within the 2-year follow-up. The majority were male (61.39%), with a median age of 62 years (interquartile range: 55–69.5). Factors independently associated with heightened the risk of recurrence stroke comprised age (hazard ratio [HR], 1.025; p = 0.021), diabetes mellitus (HR, 1.751; p = 0.007), Lp-PLA2 (HR, 1.004; p < 0.001), and Lp(a) (HR, 1.002; p < 0.001). Noteworthy is that the combination of Lp-PLA2 and Lp(a) displayed superior predictive efficacy for long-term stroke recurrence risk in AIS patients compared to individual factors.

Conclusion

This investigation underscores the potential advantage of leveraging the combined impact of Lp-PLA2 in conjunction with Lp(a) as a more precise and cost-effective predictive tool for the risk of recurrence stroke in patients with AIS.

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脂蛋白相关磷脂酶A2和脂蛋白(a)与急性缺血性卒中患者卒中复发风险的关系

目的：降低急性缺血性脑卒中（AIS）的高发病率和死亡率，改善患者预后仍是全球面临的重大挑战。本研究旨在探讨脂蛋白相关磷脂酶A2 （Lp- pla2）联合脂蛋白（Lp(a)）对AIS患者长期卒中复发的预后价值。方法：本研究纳入580例AIS患者。在患者入院时评估Lp- pla2和Lp(a)水平。长期持续监测将卒中复发分类为终点。根据确定的阈值对患者进行分类，以比较卒中复发风险：高Lp- pla2和高Lp(a)，高Lp- pla2和低Lp(a)，低Lp- pla2和高Lp(a)，低Lp- pla2和低Lp(a)，低Lp- pla2合并低Lp(a)。结果：580名参与者中，101人（17.41%）在2年随访期间出现卒中复发。男性居多（61.39%），中位年龄62岁（四分位数范围55 ~ 69.5）。与卒中再发风险增加独立相关的因素包括年龄(危险比[HR]， 1.025；p = 0.021)，糖尿病(HR, 1.751；p = 0.007), Lp-PLA2 (HR, 1.004；结论：本研究强调了利用Lp- pla2联合Lp(a)作为AIS患者卒中复发风险更精确和更具成本效益的预测工具的潜在优势。

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 Laboratory Analysis 医学-医学实验技术

CiteScore

5.60

自引率

7.40%

发文量

584

审稿时长

6-12 weeks

期刊介绍： Journal of Clinical Laboratory Analysis publishes original articles on newly developing modes of technology and laboratory assays, with emphasis on their application in current and future clinical laboratory testing. This includes reports from the following fields: immunochemistry and toxicology, hematology and hematopathology, immunopathology, molecular diagnostics, microbiology, genetic testing, immunohematology, and clinical chemistry.