Higher Lp(a) and TG/HDL-C ratio flag unstable carotid plaque in 142 acute ischaemic stroke patients (Brain Behav 2024)

Original title: The value of Lp(a) and TG/HDLC in peripheral blood to assess the stability of carotid plaque in patients with ischemic stroke

Brain Behav · 1 January 2024 · 5

Tian Y, Lu L, Zhang Y, Wei J

In 142 patients with acute ischaemic stroke, classified by carotid ultrasound into stable (59 patients) and unstable (83 patients) plaque groups, Lp(a), triglycerides, and the TG/HDL-C ratio were significantly higher in patients with unstable plaque (all P<.05), while total cholesterol, HDL-C and LDL-C did not differ between groups. Multivariate logistic regression identified Lp(a), TG/HDL-C, HbA1c, lipoprotein-associated phospholipase A2, C-reactive protein, cystatin C, homocysteine, and neutrophil-to-lymphocyte ratio as independent predictors of carotid plaque instability (all P<.05). The findings support Lp(a) and TG/HDL-C, alongside inflammatory and metabolic markers, as useful indicators of carotid plaque stability in acute ischaemic stroke.

Original abstract

Objective: The objective of this study was to investigate the relationship between lipoprotein (a) (Lp(a)), triglyceride/high-density lipoprotein cholesterol (TG/HDL-C), and the stability of carotid atherosclerotic plaque in patients with acute ischemic stroke.

Methods: A total of 142 patients with acute ischemic stroke were selected and divided into group A (59 cases of stable plaque formation) and group B (83 cases of unstable plaque formation) according to the characteristics of carotid artery plaque formation detected by carotid color Doppler ultrasound. The serum Lp(a), lipid metabolism indexes, peripheral blood routine indexes, and related serum inflammatory factors indexes were compared between the two groups. Receiver operating characteristic curve and multivariate logistic regression model were used to analyze the relationship between each index and the formation of carotid unstable plaque.

Results: There were no significant differences in serum total cholesterol (TC), HDL-C, and low-density lipoprotein cholesterol (LDL-C) between groups A and B (p > .05). The values of Lp(a), TG, and TG/HDL-C in group B were higher than those in group A, and the differences were statistically significant (p < .05). There were no significant differences in serum TC, HDL-C, and LDL-C between groups A and B (p > .05). The values of Lp(a), TG, and TG/HDL-C in group B were higher than those in group A, and the differences were statistically significant (p < .05). The values of HBA1C, Lp-PLA2, CRP, CysC, Hcy, TNF-α, neutrophils, and NLR in group B were higher than those in group A, and the differences were statistically significant (p < .05). There was no significant difference in FPG, systolic blood pressure, diastolic blood pressure, Hb, white blood cells, platelets, and lymphocytes between groups A and B (p > .05). The results of logistic regression model showed that the increase of Lp(a), TG/HDL-C, HBA1C, Lp-PLA2, CRP, CysC, Hcy, and NLR could increase the risk of carotid artery unstable plaque in patients with ischemic stroke (p < .05).

Conclusion: Lp(a) and TG/HDL-C have certain value in evaluating the stability of carotid atherosclerotic plaque in patients with acute ischemic stroke, and the increased levels of LP (a) and TG/HDL-C will significantly increase the risk of carotid unstable plaque in patients.

Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.