The Association of Lipoprotein(a) and Stroke Recurrence: A Systematic Review and Meta-Analysis
Background and Purpose Lipoprotein(a) [Lp(a)] is a lipoprotein structurally similar to low-density lipoprotein and is considered a genetically determined risk factor for cardiovascular disease. Although Lp(a) has been linked to ischemic stroke, its role in secondary stroke prevention, particularly i...
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| Language: | English |
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Korean Stroke Society
2025-05-01
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| Series: | Journal of Stroke |
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| Online Access: | http://j-stroke.org/upload/pdf/jos-2024-04623.pdf |
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| author | Lina Palaiodimou Konstantinos Melanis Maria-Ioanna Stefanou Aikaterini Theodorou Sotirios Giannopoulos Vaia Lambadiari Diana Aguiar de Sousa Simona Sacco Mira Katan Gerasimos Siasos Georgios Tsivgoulis |
| author_facet | Lina Palaiodimou Konstantinos Melanis Maria-Ioanna Stefanou Aikaterini Theodorou Sotirios Giannopoulos Vaia Lambadiari Diana Aguiar de Sousa Simona Sacco Mira Katan Gerasimos Siasos Georgios Tsivgoulis |
| author_sort | Lina Palaiodimou |
| collection | DOAJ |
| description | Background and Purpose Lipoprotein(a) [Lp(a)] is a lipoprotein structurally similar to low-density lipoprotein and is considered a genetically determined risk factor for cardiovascular disease. Although Lp(a) has been linked to ischemic stroke, its role in secondary stroke prevention, particularly in stroke recurrence, remains unclear. Methods A systematic search of MEDLINE and Scopus databases was conducted to identify randomized controlled trials (RCTs) and observational studies reporting Lp(a) levels in patients with ischemic stroke or transient ischemic attack. The primary outcome was stroke recurrence, and secondary outcomes included poor functional outcome, all-cause mortality, and recurrent vascular events. Pooled odds ratios (ORs) were calculated using a random-effects model. Results A total of 12 studies, including one RCT post hoc analysis and 11 observational studies, comprising 17,903 patients (mean age 63 years, 38% female), were included. Elevated Lp(a) levels were significantly associated with increased stroke recurrence (OR: 1.69; 95% confidence interval [CI]: 1.09–2.63; P=0.020) and poor functional outcome (OR: 2.09; 95% CI: 1.40–3.11; P<0.001). No significant associations were found between Lp(a) levels and all-cause mortality (OR: 2.20; 95% CI: 0.89–5.43; P=0.088) or recurrent vascular events (OR: 2.66; 95% CI: 0.95–7.44; P=0.063). Conclusion Elevated Lp(a) levels are linked to increased stroke recurrence and poor functional outcome in stroke patients. Lp(a) may represent a novel therapeutic target in secondary stroke prevention in addition to a promising biomarker. |
| format | Article |
| id | doaj-art-9dafc6d1653e4987902d5c71ecf0ff6d |
| institution | DOAJ |
| issn | 2287-6391 2287-6405 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Korean Stroke Society |
| record_format | Article |
| series | Journal of Stroke |
| spelling | doaj-art-9dafc6d1653e4987902d5c71ecf0ff6d2025-08-20T03:10:53ZengKorean Stroke SocietyJournal of Stroke2287-63912287-64052025-05-0127216116810.5853/jos.2024.04623577The Association of Lipoprotein(a) and Stroke Recurrence: A Systematic Review and Meta-AnalysisLina Palaiodimou0Konstantinos Melanis1Maria-Ioanna Stefanou2Aikaterini Theodorou3Sotirios Giannopoulos4Vaia Lambadiari5Diana Aguiar de Sousa6Simona Sacco7Mira Katan8Gerasimos Siasos9Georgios Tsivgoulis10 Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece Research Unit and Diabetes Center, Second Department of Internal Medicine, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece Stroke Center, Lisbon Central University Hospital – ULS São José, and Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio, Italy Department of Neurology, University Hospital Basel, University of Basel, Basel, Switzerland Third Department of Cardiology, Sotiria Thoracic Diseases General Hospital, National and Kapodistrian University of Athens, Athens, Greece Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceBackground and Purpose Lipoprotein(a) [Lp(a)] is a lipoprotein structurally similar to low-density lipoprotein and is considered a genetically determined risk factor for cardiovascular disease. Although Lp(a) has been linked to ischemic stroke, its role in secondary stroke prevention, particularly in stroke recurrence, remains unclear. Methods A systematic search of MEDLINE and Scopus databases was conducted to identify randomized controlled trials (RCTs) and observational studies reporting Lp(a) levels in patients with ischemic stroke or transient ischemic attack. The primary outcome was stroke recurrence, and secondary outcomes included poor functional outcome, all-cause mortality, and recurrent vascular events. Pooled odds ratios (ORs) were calculated using a random-effects model. Results A total of 12 studies, including one RCT post hoc analysis and 11 observational studies, comprising 17,903 patients (mean age 63 years, 38% female), were included. Elevated Lp(a) levels were significantly associated with increased stroke recurrence (OR: 1.69; 95% confidence interval [CI]: 1.09–2.63; P=0.020) and poor functional outcome (OR: 2.09; 95% CI: 1.40–3.11; P<0.001). No significant associations were found between Lp(a) levels and all-cause mortality (OR: 2.20; 95% CI: 0.89–5.43; P=0.088) or recurrent vascular events (OR: 2.66; 95% CI: 0.95–7.44; P=0.063). Conclusion Elevated Lp(a) levels are linked to increased stroke recurrence and poor functional outcome in stroke patients. Lp(a) may represent a novel therapeutic target in secondary stroke prevention in addition to a promising biomarker.http://j-stroke.org/upload/pdf/jos-2024-04623.pdflipoprotein(a)ischemic strokestroke recurrencefunctional outcomemortalitysystematic reviewmeta-analysis |
| spellingShingle | Lina Palaiodimou Konstantinos Melanis Maria-Ioanna Stefanou Aikaterini Theodorou Sotirios Giannopoulos Vaia Lambadiari Diana Aguiar de Sousa Simona Sacco Mira Katan Gerasimos Siasos Georgios Tsivgoulis The Association of Lipoprotein(a) and Stroke Recurrence: A Systematic Review and Meta-Analysis Journal of Stroke lipoprotein(a) ischemic stroke stroke recurrence functional outcome mortality systematic review meta-analysis |
| title | The Association of Lipoprotein(a) and Stroke Recurrence: A Systematic Review and Meta-Analysis |
| title_full | The Association of Lipoprotein(a) and Stroke Recurrence: A Systematic Review and Meta-Analysis |
| title_fullStr | The Association of Lipoprotein(a) and Stroke Recurrence: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Association of Lipoprotein(a) and Stroke Recurrence: A Systematic Review and Meta-Analysis |
| title_short | The Association of Lipoprotein(a) and Stroke Recurrence: A Systematic Review and Meta-Analysis |
| title_sort | association of lipoprotein a and stroke recurrence a systematic review and meta analysis |
| topic | lipoprotein(a) ischemic stroke stroke recurrence functional outcome mortality systematic review meta-analysis |
| url | http://j-stroke.org/upload/pdf/jos-2024-04623.pdf |
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