Epidemiology
Combining Lp-PLA2 with Lp(a) outperforms either marker alone for predicting stroke recurrence in 580 ischaemic stroke patients (J Clin Lab Anal 2024)
Original title: Association of Lipoprotein-Associated Phospholipase A2 and Lipoprotein(a) With the Risk of Recurrence Stroke in Patients With Acute Ischemic Stroke
In 580 patients with acute ischaemic stroke assessed for lipoprotein-associated phospholipase A2 (Lp-PLA2) and Lp(a) at admission and followed for two years, 101 patients (17.41%) experienced stroke recurrence. Independent predictors of recurrence included age (hazard ratio 1.025, p = 0.021), diabetes (hazard ratio 1.751, p = 0.007), Lp-PLA2 (hazard ratio 1.004, p < 0.001), and Lp(a) (hazard ratio 1.002, p < 0.001). Patients were stratified into four groups by combined Lp-PLA2 and Lp(a) status (high/high, high/low, low/high, low/low), and the combination of both elevated markers showed superior predictive performance for long-term stroke recurrence compared with either biomarker alone. The findings support using Lp-PLA2 and Lp(a) together as a more precise and cost-effective tool for identifying acute ischaemic stroke patients at highest risk of recurrence.
Original abstract
Objective: It is still a major global challenge to reduce the high morbidity and mortality of acute ischemic stroke (AIS) and improve the prognosis of patients. This study aims to investigate the prognostic value of lipoprotein-associated phospholipase A2 (Lp-PLA2) combined with lipoprotein(a) (Lp(a)) for long-term stroke recurrence in patients with AIS.
Methods: This study included 580 patients with AIS. Assessment of Lp-PLA2 and Lp(a) levels was conducted upon patient admission. Continuous monitoring over the long term categorized stroke recurrence as an endpoint. Patients were categorized based on these identified thresholds to compare the risk of stroke recurrence: high Lp-PLA2 and high Lp(a), high Lp-PLA2 and low Lp(a), low Lp-PLA2 and high Lp(a), and low Lp-PLA2 combined with low Lp(a).
Results: Among the 580 participants, 101 individuals (17.41%) experienced stroke recurrence within the 2-year follow-up. The majority were male (61.39%), with a median age of 62 years (interquartile range: 55-69.5). Factors independently associated with heightened the risk of recurrence stroke comprised age (hazard ratio [HR], 1.025; p = 0.021), diabetes mellitus (HR, 1.751; p = 0.007), Lp-PLA2 (HR, 1.004; p < 0.001), and Lp(a) (HR, 1.002; p < 0.001). Noteworthy is that the combination of Lp-PLA2 and Lp(a) displayed superior predictive efficacy for long-term stroke recurrence risk in AIS patients compared to individual factors.
Conclusion: This investigation underscores the potential advantage of leveraging the combined impact of Lp-PLA2 in conjunction with Lp(a) as a more precise and cost-effective predictive tool for the risk of recurrence stroke in patients with AIS.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.