TY - JOUR
T1 - High lipoprotein (a), diabetes, and the extent of symptomatic intracranial atherosclerosis
AU - Arenillas, Juan F.
AU - Molina, C. A.
AU - Chacón, P.
AU - Rovira, A.
AU - Montaner, J.
AU - Coscojuela, P.
AU - Sánchez, E.
AU - Quintana, M.
AU - Álvarez-Sabín, J.
PY - 2004/7/13
Y1 - 2004/7/13
N2 - 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.
AB - 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.
U2 - 10.1212/01.WNL.0000132637.30287.B4
DO - 10.1212/01.WNL.0000132637.30287.B4
M3 - Article
SN - 0028-3878
VL - 63
SP - 27
EP - 32
JO - Neurology
JF - Neurology
IS - 1
ER -