Lipoprotein(a) as a factor in the severity of vascular events in patients with ischemic stroke, stage 3 hypertension and multifocal atherosclerosis

Aim. To identify the features of lipid profile, coagulation system, inflammation markers and the severity of neurological status in patients with ischemic stroke (IS) and elevated lipoprotein(a) (Lp(a)).

Material and methods. The study included 109 patients (mean age 53,7±7,76 years) with ischemic stroke, multifocal atherosclerosis (MFA) and stage 3 hypertension (HTN). Depending on the Lp(a) level, the patients were divided into 2 groups. In group 1, 85 patients (78%) had Lp(a) ≤50 mg/dL, while in group 2, 24 patients (22%) had Lp(a) >50 mg/dL. All patients were assessed for lipid profile, coagulation system, high-sensitivity C-reactive protein, and interleukin-6.

Results. The target low-density lipoprotein cholesterol level <1,4 mmol/L was not achieved in any group, while all lipid profile parameters did not differ between the groups. Global hemostasis assay parameters (clot growth rate, clot size) were significantly higher in patients with Lp(a) levels >50 mg/dL. This group also had higher interleukin-6 levels (119,9 pg/ml vs 7,4 pg/ml, p<0,01) and stroke severity according to the National Institutes of Health Stroke Scale (5,7 vs 3,3, p<0,01).

Conclusion. Elevated Lp(a) levels in patients with HTN and MFA who have had ischemic stroke are a risk factor that affects the severity of neurological manifestations of ischemic stroke and is associated with hypercoagulation and inflammation. Treatment options aimed at elevated Lp(a) levels are limited, so early detection and timely correction of modifiable risk factors are necessary.

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