Epidemiology
Meta-analysis of 11,958 stroke patients finds high Lp(a) more than doubles the odds of poor functional recovery, strongest soon after stroke (Eur J Neurol 2024)
Original title: Impact of elevated lipoprotein(a) levels on the functional outcomes of ischemic stroke patients: A systematic review and meta-analysis
This systematic review and meta-analysis pooled 11 cohort studies covering 11,958 patients with ischaemic stroke to assess how baseline serum Lp(a) relates to functional outcome. High baseline Lp(a) was associated with significantly increased odds of poor functional outcome during follow-up (odds ratio 2.13, 95% CI 1.67-2.71, p < 0.001, I2 = 62%). The association was strongest at discharge (odds ratio 3.25) and remained substantial at 3 months (odds ratio 2.02) and 6 months (odds ratio 2.11), but weakened by 12 months (odds ratio 1.25, p for subgroup difference < 0.001). The association was attenuated but remained significant after adjusting for LDL cholesterol compared with unadjusted studies (odds ratio 1.69 vs. 2.63, p for subgroup difference = 0.03). High baseline Lp(a) is a robust, LDL-independent predictor of poor ischaemic stroke recovery, with its prognostic weight concentrated in the earlier recovery period.
Original abstract
Background And Purpose: Elevated serum lipoprotein(a) (Lp[a]) levels have been linked to an increased incidence of stroke. This systematic review and meta-analysis aimed to evaluate the impact of serum Lp(a) on the functional outcomes of patients with ischemic stroke (IS).
Methods: We conducted a comprehensive search of the MEDLINE, Web of Science, Embase, Wanfang, and China National Knowledge Infrastructure databases to identify relevant cohort studies. A random effects model was utilized to synthesize the data, accounting for study heterogeneity.
Results: The analysis included 11 cohort studies comprising 11,958 patients with IS. Pooled results indicated that high baseline Lp(a) levels were associated with an increased risk of poor functional outcomes during follow-up (odds ratio [OR] = 2.13, 95% confidence interval = 1.67-2.71, p < 0.001, I2 = 62%). Subgroup analyses revealed that the relationship between high Lp(a) levels and the risk of poor functional outcomes was more pronounced at discharge (OR = 3.25), 3 months (OR = 2.02), and 6 months (OR = 2.11) poststroke, compared to 12 months (OR = 1.25, p for subgroup difference < 0.001). Furthermore, the association was attenuated yet remained significant in studies adjusting for low-density lipoprotein cholesterol (LDL-C) compared to those that did not adjust for LDL-C (OR = 1.69 vs. 2.63, p for subgroup difference = 0.03).
Conclusions: High serum Lp(a) levels at baseline are significantly associated with poor functional outcomes in patients with IS.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.