title: High lipoprotein (a), diabetes, and the extent of symptomatic intracranial atherosclerosis.
abstract: BACKGROUND
  Lipoprotein (a) (Lp[a]) has important atherothrombogenic properties, but its role in intracranial atherosclerosis remains unclear.
  
  
  OBJECTIVE
  To investigate the relationship between Lp(a) level and the extent of intracranial large-artery occlusive disease.
  
  
  METHODS
  Between June 2001 and August 2003, 166 consecutive first-ever TIA or stroke patients had intracranial stenoses on transcranial Doppler, of which 100 fulfilled all inclusion criteria. The extent of intracranial large-artery occlusive disease was assessed by the number of angiographically confirmed intracranial stenoses. Serum Lp(a) was determined a minimum of 3 months after stroke onset.
  
  
  RESULTS
  Two hundred eighty-one intracranial stenoses were documented. Fifty-one (51%) patients had three or more stenoses (greater-extent group). Patients in the highest Lp(a) quartile had a higher adjusted odds ratio (OR) for a greater extent than those in the lowest quartile (OR 3.43, 95% CI 1.04 to 11.33, p = 0.04). A positive correlation was found between Lp(a) concentration and the number of stenoses (r = 0.310, p = 0.002). Moreover, Lp(a) level increased gradually with the number of stenoses (p = 0.02). A multiple logistic regression model identified diabetes (OR 2.4, 95% CI 1.04 to 5.57, p = 0.04) and high Lp(a) (OR 2.52, 95% CI 1.03 to 6.18, p = 0.043) as independent markers of a greater extent of intracranial large-artery occlusive disease.
  
  
  CONCLUSIONS
  High Lp(a) level and diabetes mellitus are independent markers of a greater extent of intracranial large-artery occlusive disease. These findings support a role for Lp(a) in intracranial stenotic atherogenesis and might be useful for the selection of high-risk patients.
authors.affiliation: Neurovascular Unit, Department of Neuroradiology, Vall d'Hebron Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain. juanfarenillas@terra.es
authors.forename: J F
authors.initials: JF
authors.lastname: Arenillas
authors.forename: C A
authors.initials: CA
authors.lastname: Molina
authors.forename: P
authors.initials: P
authors.lastname: Chacón
authors.forename: A
authors.initials: A
authors.lastname: Rovira
authors.forename: J
authors.initials: J
authors.lastname: Montaner
authors.forename: P
authors.initials: P
authors.lastname: Coscojuela
authors.forename: E
authors.initials: E
authors.lastname: Sánchez
authors.forename: M
authors.initials: M
authors.lastname: Quintana
authors.forename: J
authors.initials: J
authors.lastname: Alvarez-Sabín
mesh_terms: D000368:Aged; D015415:Biomarkers; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology*; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D002546:Ischemic Attack, Transient / Q000097:blood / Q000453:epidemiology; D017270:Lipoprotein(a) / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000097:blood / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D017270:Lipoprotein(a)