Epidemiology
High Lp(a) is associated with greater cerebral white matter hyperintensity burden in 153 stroke and TIA patients (Front Neurol 2024)
Original title: Association of white matter hyperintensities with lipoprotein (a) levels: insights from a cohort study
In a retrospective cohort of 153 patients with confirmed acute ischaemic stroke or transient ischaemic attack (mean age 45.9 years, 35.9% women), Lp(a) was stratified into low (<75 nmol/L, 60.8%), moderate (75 to <125 nmol/L, 15.0%), and high (>=125 nmol/L, 24.2%) groups, and white matter hyperintensity (WMH) burden was graded on 3-Tesla MRI using the Fazekas score. High Lp(a) was associated with a greater burden of both periventricular WMH (OR 4.4, 95% CI 1.60-12.07, P=0.004) and deep WMH (OR 5.6, 95% CI 1.69-14.7, P=0.001) compared with lower Lp(a). The findings raise the possibility that Lp(a) lowering could be a therapeutic target for WMH, though confirmation in larger cohorts is needed.
Original abstract
Background: Little is known about the relationship between lipoprotein (a) [Lp(a)] and cerebral white matter hyperintensities (WMH). The aim of the study was to examine if elevated Lp(a) levels are associated with higher burden of WMH.
Methods: We retrospectively investigated associations between Lp(a) and the burden of WMH among patients with confirmed diagnosis of acute ischemic stroke or transient ischemic attacks. WMH burden was assessed using 3-Tesla brain MRI and graded according to the Fazekas score. Multivariable models were generated to determine the contribution of Lp(a) to the presence and extent of WMH.
Results: One hundred and fifty-three patients were included (mean age, 45.9 years; 35.9% women). When the study population was stratified by Lp(a) level into three categories, low (<75 nmol/L), moderate (75 to <125 nmol/L), and high (≥125 nmol/L), the distribution of the three groups was 60.8, 15.0 and 24.2%, respectively. High Lp(a) Level was associated with higher burden of both periventricular WMH and deep WMH compared to the lower level (odds ratio [OR], 4.4; 95% confidence interval [CI], 1.60-12.07; p = 0.004; and OR, 5.6; CI, 1.69-14.7; p = 0.001, respectively).
Conclusion: We show in this cohort of patients that a higher burden of WMH was observed in patients with higher level of Lp(a). Further studies are needed to confirm this observation and assess whether lowering Lp(a) level may be a potential therapeutic target for mitigating the development of WMH.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.