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Published on: November 10, 2017
Effect of aspirin on lipoprotein(a) in patients with ischemic stroke
Gajender Singh Ranga1, Om Prakash Kalra, Himanshu Tandon
1Department of Medicine, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi, India. gajenderranga@rediffmail.com
Insights
Aspirin significantly reduces elevated lipoprotein(a) levels in patients with ischemic stroke. This study confirms aspirin
Area of Science:
- Cardiovascular Medicine
- Neurology
- Pharmacology
Background:
- Elevated serum lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerosis and ischemic stroke.
- Most lipid-lowering therapies do not affect Lp(a) levels, with niacin and aspirin being exceptions.
- This study investigates the impact of aspirin on Lp(a) in ischemic stroke patients.
Purpose of the Study:
- To evaluate serum Lp(a) and lipid levels in patients with first-ever ischemic stroke compared to healthy controls.
- To assess the effect of aspirin treatment on Lp(a) levels in these patients.
Main Methods:
- Compared Lp(a) and lipid levels in 25 ischemic stroke patients (aged 21-60) with 25 age- and sex-matched healthy controls.
- Administered 150 mg of aspirin daily to patients for 4 weeks and measured Lp(a) levels before and after treatment.
- Analyzed anthropometric measurements, routine laboratory parameters, and erythrocyte sedimentation rate.
Main Results:
- Ischemic stroke patients had significantly higher Lp(a) levels (27.40 ± 22.30 mg/dL) than controls (14.68 ± 11.75 mg/dL).
- 80% of patients had Lp(a) > 10 mg/dL, compared to 44% of controls (P = .009).
- Aspirin treatment reduced Lp(a) levels by 46.24% (P < .001), with greater reduction in patients with higher baseline levels.
Conclusions:
- Elevated Lp(a) is prevalent in younger patients with first-ever ischemic stroke.
- Aspirin effectively lowers increased Lp(a) levels in patients with ischemic stroke.
- Aspirin may offer a therapeutic strategy for managing elevated Lp(a) in ischemic stroke patients.
Abstract:
Hyperlipidemia and increased serum lipoprotein (Lp)(a) are independent risk factors for atherosclerosis and its complications. Serum Lp(a) concentration is not influenced by most lipid-lowering therapies other than niacin. Recently aspirin also has been reported to decrease its levels. In the current study, we evaluated the serum levels of Lp(a) and lipids in 25 patients with first-ever diagnosed ischemic stroke, aged 21 to 60 years, and compared their levels with an equal number of age- and sex-matched healthy control subjects. In addition, the effect of aspirin on Lp(a) levels was studied by estimating its levels after 4 weeks of daily treatment with 150 mg of aspirin. Both groups were comparable regarding their anthropometric measurements and routine laboratory parameters except that erythrocyte sedimentation rate was higher in the patients. Serum lipids were not significantly different between the two groups, although Lp(a) levels were significantly higher in the patients (27.40 +/- 22.30 mg/dL) as compared with the control subjects (14.68 +/- 11.75 mg/dL) (P = .005). Twenty of 25 patients (80%) had serum Lp(a) levels of more than 10 mg/dL, whereas only 11 of 25 control subjects (44%) had serum Lp(a) levels of more than 10 mg/dL (P = .009). After 4 weeks of treatment with aspirin, Lp(a) levels declined significantly (46.24%) from baseline 27.40 +/- 22.30 mg/dL to 14.73 +/- 10.47 mg/dL (P < .001). Patients with baseline levels greater than 25 mg/dL showed greater decline (55.63%) compared with those with levels less than 25 mg/dL (26.63%) (P = .008). Results of our study confirm that aspirin lowers the increased Lp(a) levels in patients with ischemic stroke.
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