%0 Journal Article
%T The joint association of lipoprotein(a) and Lp-PLA2 with the risk of stroke recurrence.
%A Xue J
%A Xiang Y
%A Jiang X
%A Jin A
%A Hao X
%A Li K
%A Lin J
%A Meng X
%A Li H
%A Zheng L
%A Wang Y
%A Xu J
%J J Clin Lipidol
%V 0
%N 0
%D 2024 May 6
%M 38981820
%F 5.365
%R 10.1016/j.jacl.2024.04.133
%X <B>OBJECTIVE: </B>Currently little is known about the joint association of lipoprotein (a) [Lp(a)] and Lipoprotein-associated phospholipase A2 (Lp-PLA2) with stroke recurrence.<BR><B>METHODS: </B>In this prospective multicenter cohort study, 10,675 consecutive acute ischemic stroke (IS) and transient ischemic attack patients (TIA) with Lp(a) and Lp-PLA2 were enrolled. The association of stroke recurrence within 1 year with Lp(a) and Lp-PLA2 was assessed using Cox proportional hazards models and Kaplan-Meier curves. The interaction between Lp(a) and Lp-PLA2 with stroke recurrence was evaluated by multiplicative and additive scales.<BR><B>RESULTS: </B>A significant joint association of Lp(a) and Lp-PLA2 with the risk of stroke recurrence was observed. Multivariate cox regression analysis demonstrated that the combination of elevated Lp(a) (≥ 50 mg/dL) and Lp-PLA2 (≥175.1 ng/ml) was independently associated with the risk of stroke recurrence (adjusted hazard ratio: 1.42; 95 % CI: 1.15-1.76). Both significant multiplicative [(exp(β3):1.63, 95 % CI: 1.17-2.29, P = 0.004] and additive interaction (RERI:0.55, 95 % CI: 0.20-0.90, P = 0.002; AP: 0.39, 95 %CI, 0.24-0.53) were observed between Lp(a) and Lp-PLA2.<BR><B>CONCLUSIONS: </B>Our results indicated that Lp(a) and Lp-PLA2 have a joint association with the risk of stroke recurrence in IS/TIA patients. Patients with concomitant presence of elevated Lp(a) and Lp-PLA2 have greater risk of stroke recurrence.