Epidemiology
High Lp(a) (>30 mg/dL) raises ischaemic stroke risk in atrial fibrillation patients across four adjustment models, in 2,258 propensity-matched patients (Int J Gen Med 2024)
Original title: The Association of High Lipoprotein(a) Concentration and Risk of Ischaemic Stroke in Atrial Fibrillation Patients
In a retrospective, propensity-score-matched cohort of 2,258 patients (1,129 with atrial fibrillation, 1,129 without) at a Chinese hospital, median Lp(a) was higher in patients who had an ischaemic stroke than in controls (17.03 vs 15.36 mg/dL, P=0.032). Lp(a) >30.00 mg/dL was consistently associated with increased ischaemic stroke risk across four progressively adjusted models, with odds ratios of 1.263, 1.284, 1.297 and 1.290 (all P<=0.015), and the association held in stratified analyses by sex, age 60 or younger, hypertension, and absence of coronary heart disease. The findings support elevated Lp(a) as an independent risk factor for ischaemic stroke specifically in patients with atrial fibrillation.
Original abstract
Background: Lipoprotein(a) [Lp(a)] is a well-established risk factor for ischaemic stroke (IS). It is unclear whether Lp(a) is associated with IS in patients with atrial fibrillation (AF). The aim of this study is to explore the association between the concentration of Lp(a) and the risk of IS in AF patients, hope to find the potential risk factor for the IS in AF patients.
Methods: This study is a retrospective cohort study. The screened AF patients between January 2017 and July 2021 were matched at 1:1 by the propensity score matching (PSM) method in the Second Affiliated Hospital of Nanchang University. Associations between Lp(a) and ischaemic stroke were analysed using logistic regression models, stratified analysis and sensitivity analysis. Statistical analyses were conducted using IBM SPSS software.
Results: The number of enrolled participates is 2258, which contains 1129 non-AF patients and 1129 AF patients. Among IS patients, the median Lp(a) concentration was higher than that of controls (17.03 vs. 15.36 mg/dL, P = 0.032). The Spearman rank-order correlation coefficients revealed significant positive relationships between IS and Lp(a) (P = 0.032). In addition, a significant increase in IS risk was associated with Lp(a) levels >30.00 mg/dL in unadjusted model [OR:1.263, 95% CI(1.046-1.523), P = 0.015], model 1 [OR:1.284, 95% CI(1.062,1.552), P = 0.010], model 2 [OR: 1.297, 95% CI(1.07,1.573). P = 0.008], and model 3 [OR: 1.290, 95% CI (1.064, 1.562). P = 0.009]. The stratified analysis indicated that this correlation was not affected by female sex [1.484 (1.117, 1.972), P = 0.006], age ≤ 60 [1.864 (1.067-3.254), P=0.029], hypertension [1.359 (1.074, 1.721), P = 0.011], or non-coronary heart disease (CHD) [1.388 (1.108, 1.738), P = 0.004].
Conclusion: High levels of Lp(a) were significantly related to IS in AF patients and may be a potential risk factor in the onset of an IS in AF patients.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.