Lipoprotein (a) and the risk of ischemic stroke in young women.
OBJECTIVE
lipoprotein (a) (lp (a)) is a lipid-containing particle similar to LDL which has been found in atherosclerotic plaque. The role of lp (a) in ischemic stroke remains controversial, but some studies suggest lp (a) is particularly important as a risk factor for stroke in young adults. We investigated the role of lp (a) as a risk factor for stroke in young women enrolled in the Stroke Prevention in Young Women Study.


METHODS
subjects were participants in a population-based, case-control study of risk factors for ischemic stroke in young women. Cases were derived from surveillance of 59 regional hospitals in the central Maryland, Washington DC, Pennsylvania and Delaware area. Lp (a) was measured in 110 cases and 216 age-matched controls. Demographics, risk factors, and stroke subtype were determined by interview and review of medical records.


RESULTS
lp (a) values were higher in blacks than whites, but within racial groups, the distribution of lp (a) values was similar between cases and controls. After adjustment for age, race, hypertension, diabetes, cigarette smoking, coronary artery disease, total cholesterol and HDL cholesterol, the odds ratio for an association of lp (a) and stroke was 1.36 (95% CI 0.80-2.29). There was no dose-response relationship between lp (a) quintile and stroke risk. Among stroke subtypes, only lacunar stroke patients had significantly elevated lp (a) values compared to controls.


CONCLUSIONS
we found no association of lp (a) with stroke in a population of young women with ischemic stroke. Small numbers of patients limit conclusions regarding risk in ischemic stroke subtypes, but we could not confirm previous suggestions of an association of lp (a) with atherosclerotic stroke in young adults.
Wityk
R J
RJ
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. rwityk@jhmi.edu
Kittner
S J
SJ
Jenner
J L
JL
Hebel
J R
JR
Epstein
A
A
Wozniak
M A
MA
Stolley
P D
PD
Stern
B J
BJ
Sloan
M A
MA
Price
T R
TR
McCarter
R J
RJ
Macko
R F
RF
Johnson
C J
CJ
Earley
C J
CJ
Buchholz
D W
DW
Schaefer
E J
EJ
D000293:Adolescent; D000328:Adult; D001161:Arteriosclerosis / Q000097:blood / Q000150:complications / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002544:Cerebral Infarction / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D003327:Coronary Disease / Q000097:blood / Q000150:complications / Q000453:epidemiology; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications / Q000453:epidemiology; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000453:epidemiology; D017270:Lipoprotein(a) / Q000097:blood*; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D044469:Racial Groups; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D015415:Biomarkers; D017270:Lipoprotein(a)