Jing Xue MD, PhD , Yukun Xiang MD , Xue Jiang PhD , Aoming Jin PhD , Xiwa Hao MD, PhD , Ke Li MD , Jinxi Lin PhD , Xia Meng MD, PhD , Hao Li PhD , Lemin Zheng PhD , Yongjun Wang MD, PhD , Jie Xu MD, PhD
{"title":"脂蛋白（a）和脂蛋白-PLA2 与中风复发风险的共同关系","authors":"Jing Xue MD, PhD , Yukun Xiang MD , Xue Jiang PhD , Aoming Jin PhD , Xiwa Hao MD, PhD , Ke Li MD , Jinxi Lin PhD , Xia Meng MD, PhD , Hao Li PhD , Lemin Zheng PhD , Yongjun Wang MD, PhD , Jie Xu MD, PhD","doi":"10.1016/j.jacl.2024.04.133","DOIUrl":null,"url":null,"abstract":"<div><h3>BACKGROUND AND PURPOSE</h3><div>Currently little is known about the joint association of lipoprotein (a) [Lp(a)] and lipoprotein-associated phospholipase A2 (Lp-PLA2) with stroke recurrence.</div></div><div><h3>METHODS</h3><div>In this prospective multicenter cohort study, 10,675 consecutive acute ischemic stroke (IS) and transient ischemic attack (TIA) patients with Lp(a) and Lp-PLA2 were enrolled. The association of stroke recurrence within 1 year with Lp(a) and Lp-PLA2 was assessed using Cox proportional hazards models and Kaplan-Meier curves. The interaction between Lp(a) and Lp-PLA2 with stroke recurrence was evaluated by multiplicative and additive scales.</div></div><div><h3>RESULTS</h3><div>A significant joint association of Lp(a) and Lp-PLA2 with the risk of stroke recurrence was observed. Multivariate Cox regression analysis demonstrated that the combination of elevated Lp(a) (≥ 50 mg/dL) and Lp-PLA2 (≥175.1 ng/mL) was independently associated with the risk of stroke recurrence (adjusted hazard ratio: 1.42; 95% confidence interval [CI]: 1.15–1.76). Both significant multiplicative [(exp(β3): 1.63, 95% CI: 1.17–2.29, <em>P</em> = 0.004] and additive interaction (RERI: 0.55, 95% CI: 0.20–0.90, <em>P</em> = 0.002; AP: 0.39, 95% CI, 0.24–0.53) were observed between Lp(a) and Lp-PLA2.</div></div><div><h3>CONCLUSIONS</h3><div>Our results indicated that Lp(a) and Lp-PLA2 have a joint association with the risk of stroke recurrence in IS/TIA patients. Patients with concomitant presence of elevated Lp(a) and Lp-PLA2 have greater risk of stroke recurrence.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"18 5","pages":"Pages e729-e737"},"PeriodicalIF":3.6000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The joint association of lipoprotein(a) and lipoprotein-associated phopholipase A2 with the risk of stroke recurrence\",\"authors\":\"Jing Xue MD, PhD , Yukun Xiang MD , Xue Jiang PhD , Aoming Jin PhD , Xiwa Hao MD, PhD , Ke Li MD , Jinxi Lin PhD , Xia Meng MD, PhD , Hao Li PhD , Lemin Zheng PhD , Yongjun Wang MD, PhD , Jie Xu MD, PhD\",\"doi\":\"10.1016/j.jacl.2024.04.133\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>BACKGROUND AND PURPOSE</h3><div>Currently little is known about the joint association of lipoprotein (a) [Lp(a)] and lipoprotein-associated phospholipase A2 (Lp-PLA2) with stroke recurrence.</div></div><div><h3>METHODS</h3><div>In this prospective multicenter cohort study, 10,675 consecutive acute ischemic stroke (IS) and transient ischemic attack (TIA) patients with Lp(a) and Lp-PLA2 were enrolled. The association of stroke recurrence within 1 year with Lp(a) and Lp-PLA2 was assessed using Cox proportional hazards models and Kaplan-Meier curves. The interaction between Lp(a) and Lp-PLA2 with stroke recurrence was evaluated by multiplicative and additive scales.</div></div><div><h3>RESULTS</h3><div>A significant joint association of Lp(a) and Lp-PLA2 with the risk of stroke recurrence was observed. Multivariate Cox regression analysis demonstrated that the combination of elevated Lp(a) (≥ 50 mg/dL) and Lp-PLA2 (≥175.1 ng/mL) was independently associated with the risk of stroke recurrence (adjusted hazard ratio: 1.42; 95% confidence interval [CI]: 1.15–1.76). Both significant multiplicative [(exp(β3): 1.63, 95% CI: 1.17–2.29, <em>P</em> = 0.004] and additive interaction (RERI: 0.55, 95% CI: 0.20–0.90, <em>P</em> = 0.002; AP: 0.39, 95% CI, 0.24–0.53) were observed between Lp(a) and Lp-PLA2.</div></div><div><h3>CONCLUSIONS</h3><div>Our results indicated that Lp(a) and Lp-PLA2 have a joint association with the risk of stroke recurrence in IS/TIA patients. Patients with concomitant presence of elevated Lp(a) and Lp-PLA2 have greater risk of stroke recurrence.</div></div>\",\"PeriodicalId\":15392,\"journal\":{\"name\":\"Journal of clinical lipidology\",\"volume\":\"18 5\",\"pages\":\"Pages e729-e737\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of clinical lipidology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1933287424001818\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of clinical lipidology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1933287424001818","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
The joint association of lipoprotein(a) and lipoprotein-associated phopholipase A2 with the risk of stroke recurrence
BACKGROUND AND PURPOSE
Currently little is known about the joint association of lipoprotein (a) [Lp(a)] and lipoprotein-associated phospholipase A2 (Lp-PLA2) with stroke recurrence.
METHODS
In this prospective multicenter cohort study, 10,675 consecutive acute ischemic stroke (IS) and transient ischemic attack (TIA) patients with Lp(a) and Lp-PLA2 were enrolled. The association of stroke recurrence within 1 year with Lp(a) and Lp-PLA2 was assessed using Cox proportional hazards models and Kaplan-Meier curves. The interaction between Lp(a) and Lp-PLA2 with stroke recurrence was evaluated by multiplicative and additive scales.
RESULTS
A significant joint association of Lp(a) and Lp-PLA2 with the risk of stroke recurrence was observed. Multivariate Cox regression analysis demonstrated that the combination of elevated Lp(a) (≥ 50 mg/dL) and Lp-PLA2 (≥175.1 ng/mL) was independently associated with the risk of stroke recurrence (adjusted hazard ratio: 1.42; 95% confidence interval [CI]: 1.15–1.76). Both significant multiplicative [(exp(β3): 1.63, 95% CI: 1.17–2.29, P = 0.004] and additive interaction (RERI: 0.55, 95% CI: 0.20–0.90, P = 0.002; AP: 0.39, 95% CI, 0.24–0.53) were observed between Lp(a) and Lp-PLA2.
CONCLUSIONS
Our results indicated that Lp(a) and Lp-PLA2 have a joint association with the risk of stroke recurrence in IS/TIA patients. Patients with concomitant presence of elevated Lp(a) and Lp-PLA2 have greater risk of stroke recurrence.
期刊介绍：
Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.
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