Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Relationship Between Lipoprotein (a) [Lp(a)] and Cognition in Different Ischemic Stroke Subtypes
First author：Jingjing Li,Shiyu Li
Corresponding author：Yongjun Wang
essential_information
- Person in charge：Jingjing Li,Shiyu Li
- Data Sources： ICONS
- Number of papers：ICONS20210017
- Published time：2021-12-03
2021-12-03
Published articles
Journal：Frontiers in Neurology.
Publication type: Original Contributions
IF(IF): 4.003
PMID: 34925208 Link To Pubmed Full text Download
Background And Purpose
Lp(a) plays a role in atherosclerosis and thrombosis. Elevated Lp(a) level was found to be an independent risk factor for ischemic stroke in a recent meta-analysis. One-third of stroke survivors are found to have a significant degree of cognitive impairment within the first months after the events. Studies were controversial about the relation between serum Lp(a) and cognitive function. A mendelian randomization study demonstrated that Lp(a) concentrations was causally associated with an increased risk of large artery stroke but a decreased risk of small vessel stroke and Alzheimer disease. In this study, we aimed to investigate the association between serum Lp(a) levels and cognitive impairment after AIS or TIA and analyse it in different stroke subtypes.
Method
The study included 1,017 patients diagnosed with AIS or TIA from the cognition subgroup of the Third China National Stroke Registry (CNSR3). Montreal Cognitive Assessment (MoCA) at 2 weeks or discharge, 3 months, and 1 year was evaluated. The primary outcome was cognitive impairment at 1 year, defined as MoCA ≤ 22. The secondary outcome was cognition improvement at 1 year compared with 2 weeks. The association between Lp(a) levels and cognitive function was analyzed.
Conclusion
Higher Lp(a) level was associated with cognitive impairment and less improvement of cognition in patients after AIS or TIA with large-artery atherosclerosis subtype.
Main results
Among the 1,017 patients included, 326 (32.1%) had cognitive impairment at 1 year. Patients with MoCA ≤ 22 at 1 year were older, received less education, and had higher baseline NIHSS, higher proportion of ischemic stroke history, large artery atherosclerosis (LAA) subtype, and multiple infarctions (P < 0.05 for all). Patients with highest Lp(a) quartile had slightly higher percentage of cognitive impairment at 1 year but without statistical difference. In subgroup analysis of LAA subtype, the patients with highest Lp(a) quartile had higher percentage of cognitive impairment at 1 year (adjusted OR:2.63; 95% CI: 1.05–6.61, P < 0.05). What is more, the patients with highest Lp(a) quartile in LAA subtype had lower percentage of cognition improvement at 1 year. However, similar results were not found in small artery occlusion (SAO) subtype.