Epidemiology
Higher Lp(a) independently predicts cognitive impairment after ischaemic stroke, 790-patient Chinese study finds (Br J Hosp Med (Lond) 2025)
Original title: The Correlation Between Lipoprotein(a) and Cognitive Impairment in Patients With Ischemic Stroke
This single-centre cross-sectional study analysed 790 ischaemic stroke patients from the Affiliated Hospital of Xuzhou Medical University between January 2017 and December 2023, split into lower and higher Lp(a) groups by the median level, to assess the relationship between Lp(a) and cognitive impairment. Cognitive impairment was significantly more prevalent in the higher-Lp(a) group (P < 0.001), and after adjusting for confounders, the higher-Lp(a) group had 1.735 times the risk of cognitive impairment (P = 0.001), with each unit increase in Lp(a) raising risk by 0.1% (P = 0.001). This association remained stable across nearly all subgroups, including after excluding patients with prior stroke, though it lost significance in the subgroup without hypertension; ROC analysis showed Lp(a) had predictive value in the overall population and in both sexes, and restricted cubic spline analysis confirmed a linear, non-threshold relationship between Lp(a) and cognitive impairment risk (P < 0.001, P nonlinear = 0.828). The authors conclude higher Lp(a) is an independent risk factor for cognitive impairment following ischaemic stroke.
Original abstract
Aims/Background Lipoprotein(a) [Lp(a)] has been implicated in cerebrovascular diseases and may contribute to cognitive decline. Thus, this study sought to assess cognitive impairment in ischemic stroke patients and its association with Lp(a). Methods This single-center cross-sectional study included 790 patients from the Affiliated Hospital of Xuzhou Medical University between January 2017 and December 2023, categorized into lower and higher Lp(a) groups based on the median Lp(a) levels. Logistic regression analysis, subgroup analysis, sensitivity analysis, receiver operating characteristic (ROC) curve analysis, and restricted cubic spline (RCS) analysis were conducted to explore the association between Lp(a) and cognitive impairment. Results The higher Lp(a) group showed a greater prevalence of cognitive impairment than the lower Lp(a) group (p < 0.001). After accounting for all potential influences, the risk of cognitive impairment was 1.735 times higher in the higher Lp(a) group than in the lower Lp(a) group (p = 0.001), and for each unit increase in Lp(a), the risk of cognitive impairment increased by 0.1% (p = 0.001). Subgroup analysis indicated that the significant association between Lp(a) and cognitive impairment remained stable in all subgroups except for the subgroup without hypertension (p < 0.05). Additionally, even after omitting those with prior stroke, higher Lp(a) levels remained independently linked to an increased risk of cognitive impairment (p < 0.05). ROC analysis revealed that Lp(a) had predictive value for cognitive impairment in the overall population, as well as in male and female patients (p < 0.05). In the multivariate-adjusted regression model, a linear relationship between Lp(a) and cognitive impairment risk was demonstrated by RCS analysis (p < 0.001, p nonlinear = 0.828). Conclusion Higher levels of Lp(a) are independently linked to a greater risk of cognitive impairment in stroke patients.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.