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Study of Association of Lipoprotein (A) Levels with Carotid Atherosclerosis in Young Patients with Ischemic Stroke

Pooja Gupta, Consultant Neurology, Shri Mata Vaishno Devi Narayana Superspeciality Hospital, Jammu, Jammu and Kashmir 182320, India. , Pooja Gupta1 , Ish Anand2 , Anuradha Batra3 , P.K. Sethi4 , Rajat Mohan5 , L.M. Srivastava6 , Samir Patel7 , Davinder Singh Rana8

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International Journal of Neurology and Neurosurgery 10(4):p 133-138, Oct-Dec 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.10418.7

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Abstract

  Context: Lipoprotein (a) is an established risk factor for coronary artery disease but its role as a risk factor for stroke is not established. Aims: To estimate the prevalence of elevated levels of lipoprotein (a) in young patients (18-55 years) with ischemic stroke and to study the association between lipoprotein (a) plasma concentration and carotid atherosclerosis Settings and Design: This observational, cross-sectional, single center study was conductedon 90 young (18-55 years) patients with imaging confirmed ischemic stroke for a duration of 1 year. Lipoprotein (a) samples were taken within 24 hours of presentation to the hospital and values >30mg/dL were considered abnormal. Carotid Doppler was done by a cardiologist unaware of history of patientsl. Patients were divided into two groups: Group A (normal) and Group B (abnormal). Average values of lipoprotein (a) levels in both the groups were taken and compared using appropriate statistical analysis. Results: There were 65 males and 25 females in the study. Prevalence of elevated lipoprotein (a) in the study population was found to be 44.4%. It was more than the other traditional risk factors for stroke. Prevalence of carotid atherosclerosis and carotid stenosis in the study was 41.1% and 31.1% respectively. Elevation of lipoprotein (a) was strongly associated with carotid atherosclerosis (p=0.001). Mean values of lipoprotein (a) were statistically higher in the atherosclerosis group than in no atherosclerosis group (p=0.002). Lipoprotein (a) was positively associated with carotid stenosis in a graded manner but its association with CIMT was not significant. The association of lipoprotein (a) and carotid atherosclerosis was independent of other risk factors.

Conclusion: Lipoprotein (a) is strongly associated with carotid atherosclerosis (especially carotid stenosis) in young patients with ischemic stroke and the association is independent of the traditional risk factors. 

Keywords: Ischemic Stroke; Young Population; Lipoprotein (a); Carotid Atherosclerosis.

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DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.10418.7

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