Serum Lipoprotein (A) Levels in Young Ischemic Stroke: A Prospective Study

Abstract

Background and Aims: Ischemic stroke in young adults (≤40 years) is a significant cause of morbidity, with emerging risk factors like lipoprotein (a) [Lp(a)] gaining attention. This study aimed to evaluate serum Lp(a) levels in young ischemic stroke patients and assess its role as an independent risk factor, its variation with age, and its association with recurrent stroke and infarct severity.
Materials and Methods: A cross-sectional observational study was conducted at Thanjavur Medical College Hospital from January 2021 to October 2022, involving 50 patients aged ≤40 years with confirmed ischemic stroke via CT scan. Patients with hypertension, diabetes, or other major risk factors were excluded. Serum Lp(a) levels were measured using nephelometry, and data on demographics, clinical presentation, and outcomes were collected. Statistical analysis was performed using GraphPad Prism version 5, employing Fisher’s exact test, unpaired t-tests, and Pearson’s correlation.
Results: Of the 50 patients, 68% were male, and 50% were aged 25–35 years. Elevated Lp(a) levels (≥30 mg/dl) were observed in 56% of patients, with a mean Lp(a) of 79.7 mg/dl in massive infarct cases compared to 37.4 mg/dl in non-massive infarcts (p=0.0003). Lp(a) levels showed a weak positive correlation with age (r=0.323, p=0.022). All six patients with recurrent stroke had elevated Lp(a) levels. The odds ratio for massive infarcts with high Lp(a) was 13 (95% CI: 0.69–244.9, p=0.028).
Conclusion: Elevated Lp(a) is prevalent in young ischemic stroke patients and is an independent risk factor. Higher Lp(a) levels are associated with massive infarcts and may predict recurrent stroke. Further studies are needed to explore therapeutic interventions targeting Lp(a).