Lipoprotein (a) and apolipoprotein E epsilon 4 as independent risk factorsfor ischemic stroke

Background Controversies exist concerning the association between serum lip ids and ischemic stroke. Objective To investigate the relationship between serum lipid, apolipoprote in E (apoE) genotype and risk of ischemic stroke. Methods We measured the concentrations of serum lipids, lipoprotein (a) [Lp (a)], and apoE genotype, as well as the distribution of other potential ris k factors, in 90 pairs of age- and sex-matched ischemic stroke patients and stroke-free controls. Results The prevalence of hypertension, family history of stroke and hypert ension, and smoking and drinking habits were significantly higher in cases than in controls. Total cholesterol, low-density lipoprotein cholesterol, a nd Lp(a) levels were higher in ischemic stroke patients than in controls (5 .7 +/- 1.2 versus 5.3 +/- 1.2 mmol/l, P < 0.05; 3.7 +/- 1.0 versus 3.1 +/- 1.0 mmol/l, P < 0.01; and 197.6 +/- 30.6 versus 90.4 +/- 11.2 mg/l, P < 0.0 1, respectively). The cases had lower high-density lipoprotein cholesterol and apolipoprotein A-I concentrations compared with the controls. The apoE epsilon 3/epsilon 4 genotype was more frequent in cases (21.1%) than in con trols (8.9%, P < 0.05). Conclusion The results of the study indicate that serum Lp(a) level and apo E epsilon 4 are the prominent lipidic predictors for ischemic stroke in add ition to the general risk factors such as history of hypertension, family h istory of stroke and cigarette smoking, J Cardiovasc Risk 6:1-6 (C) 1999 Li ppincott Williams & Wilkins.