Lipoprotein (a) and stroke

Strokes are one of the most common causes of mortality and long term severe disability. There is evidence that lipoprotein (a) (Lp(a)) is a predictor of many forms of vascular disease, including premature coronary artery dise ase. Several studies have also evaluated the association between Lp(a) and ischaemic (thrombotic) stroke. Several cross sectional (and a few prospecti ve) studies provide contradictory findings regarding Lp(a) as a predictor o f ischaemic stroke. Several factors might contribute to the existing confus ion-for example, small sample sizes, different ethnic groups, the influence of oestrogens in women participating in the studies, plasma storage before Lp(a) determination, statistical errors, and selection bias. This review f ocuses on the Lp(a) related mechanisms that might contribute to the pathoge nesis of ischaemic stroke. The association between Lp(a) and other cardiova scular risk factors is discussed. Therapeutic interventions that can lower the circulating concentrations of Lp(a) and thus possibly reduce the risk o f stroke are also considered.