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

Controversies exist concerning the association between serum lipids and ischemic stroke.

To investigate the relationship between serum lipid, apolipoprotein E (apoE) genotype and risk of ischemic stroke.

We measured the concentrations of serum lipids, lipoprotein (a) [Lp(a)], and apoE genotype, as well as the distribution of other potential risk factors, in 90 pairs of age- and sex-matched ischemic stroke patients and stroke-free controls.

The prevalence of hypertension, family history of stroke and hypertension, and smoking and drinking habits were significantly higher in cases than in controls. Total cholesterol, low-density lipoprotein cholesterol, and 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 < 0.01, respectively). The cases had lower high-density lipoprotein cholesterol and apolipoprotein A-1 concentrations compared with the controls. The apoE epsilon 3/epsilon 4 genotype was more frequent in cases (21.1%) than in controls (8.9%, P < 0.05).

The results of the study indicate that serum Lp(a) level and apoE epsilon 4 are the prominent lipidic predictors for ischemic stroke in addition to the general risk factors such as history of hypertension, family history of stroke and cigarette smoking.