LIPOPROTEIN(A) AND ISCHEMIC CEREBROVASCULAR-DISEASE IN YOUNG-ADULTS

Background and Purpose Serum lipoprotein(a) level is genetically deter mined and remains almost constant throughout life. Based on this prope rty, we investigated the serum lipoprotein(a) levels of ischemic strok e patients in the chronic stage (mean period after stroke, 27 months) and its relation to the types of ischemic stroke. Methods We measured serum lipoprotein(a) levels in 101 patients with chronic ischemic stro ke and 37 normal control subjects, taking the clinical profiles into c onsideration. Results Lipoprotein(a) levels in patients with atherothr ombotic stroke were 28.0+/-19.6 mg/dL (mean+/-SD), which were signific antly (P<.01) higher than those in patients with lacunar stroke and in normal control subjects (16.4+/-13.5 and 11.7+/-10.5 mg/dL, respectiv ely). The lipoprotein(a) levels in patients with atherothrombotic stro ke were significantly higher in the subgroup who were a younger age at onset: onset before age 50 years, 35.3+/-20.5; onset at age 50 to 59, 35.4+/-21.7; onset at age 60 to 69, 17.0+/-12.8; and onset at age 70 or older, 16.3+/-6.8 mg/dL (P<.01 for onset before age 50 versus 60 to 69 years or 70 years or older; P<.01 for onset at 50 to 59 years vers us 60 to 69 years or 70 years or older). Serum lipoprotein( a) was sig nificantly increased (40.2+/-20.1 mg/dL) in young adults with atheroth rombotic stroke (onset at younger than age 45 years) compared with tha t in patients older than 45 years (P<.01). Conclusions We conclude tha t lipoprotein(a) is a genetic, independent, and critical risk factor f or ischemic stroke, especially in young adults.