Lipoprotein (a) and the risk of ischemic stroke in young women

Background and purpose: lipoprotein (a) (lp (a)) is a lipid-containing part icle similar to LDL which has been found in atherosclerotic plaque. The rol e of lp (a) in ischemic stroke remains controversial, but some studies sugg est lp (a) is particularly important as a risk factor for stroke in young a dults. We investigated the role of lp (a) as a risk factor for stroke in yo ung women enrolled in the Stroke Prevention in Young Women Study. Methods: subjects were participants in a population-based, case-control study of ris k factors for ischemic stroke in young women. Cases were derived from surve illance of 59 regional hospitals in the central Maryland, Washington DC, Pe nnsylvania and Delaware area. Lp (a) was measured in 110 cases and 216 age- matched controls. Demographics, risk factors, and stroke subtype were deter mined by interview and review of medical records. Results: lp (a) values we re higher in blacks than whites, but within racial groups, the distribution of lp (a) values was similar between cases and controls. After adjustment for age, race, hypertension, diabetes, cigarette smoking, coronary artery d isease, total cholesterol and HDL cholesterol, the odds ratio for an associ ation of lp (a) and stroke was 1.36 (95% CI 0.80-2.29). There was no dose-r esponse relationship between lp (a) quintile and stroke risk. Among stroke subtypes, only lacunar stroke patients had significantly elevated lp (a) va lues compared to controls. Conclusions: we found no association of lp (a) w ith stroke in a population of young women with ischemic stroke. Small numbe rs of patients limit conclusions regarding risk in ischemic stroke subtypes , but we could not confirm previous suggestions of an association of lp (a) with atherosclerotic stroke in young adults. (C) 2000 Elsevier Science Ire land Ltd. All rights reserved.