Lipoprotein (a) as a risk factor for ischemic stroke: a meta-analysis
Nave AH, Lange KS, Leonards CO, Siegerink B, Doehner W, Landmesser U, Steinhagen-Thiessen E, Endres M, Ebinger M
Atherosclerosis · 148 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- Bundesministerium für Bildung und Forschung
- Universidad u hospital
- Center for Stroke Research Berlin
Según 2 financiadores declarados.
Publicación
- Publicado
- 2015-08-15 · Atherosclerosis · vol. 242 · número 2 · págs. 496–503
- Editorial
- Elsevier BV
- Citado
- 200 citas · más que el 90% de estudios similares · 2.4× el promedio de su campo
- Referencias
- 78 trabajos
- Acceso
- De pago
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Acute Ischemic Stroke Management · Cerebrovascular and Carotid Artery Diseases
- Palabras clave
- lipoprotein(a), ischemic stroke, stroke risk factors, sex differences, young stroke patients, stroke subtypes, age as confounder
- MeSH
- humans, ischemic attack, transient, ischemia, lipoprotein(a), risk factors, age factors, sex factors, research design, middle aged, female, male, atherosclerosis, stroke
9 autores
- Alexander H. Nave🇩🇪 · autor de correspondenciaGerman Centre for Cardiovascular Research; Center for Stroke Research Berlin; Charité - Universitätsmedizin Berlin
- Kristin Sophie Lange🇩🇪Center for Stroke Research Berlin; Charité - Universitätsmedizin Berlin
- Christopher O. Leonards🇩🇪Center for Stroke Research Berlin; Charité - Universitätsmedizin Berlin
- Bob Siegerink🇩🇪Center for Stroke Research Berlin; Charité - Universitätsmedizin Berlin
- Wolfram Doehner🇩🇪German Centre for Cardiovascular Research; Center for Stroke Research Berlin; Charité - Universitätsmedizin Berlin
- Ulf Landmesser🇩🇪German Centre for Cardiovascular Research; Charité - Universitätsmedizin Berlin
- Elisabeth Steinhagen‐Thiessen🇩🇪Charité - Universitätsmedizin Berlin
- Matthias Endres🇩🇪German Center for Neurodegenerative Diseases; German Centre for Cardiovascular Research; Center for Stroke Research Berlin; Charité - Universitätsmedizin Berlin
- Martin Ebinger🇩🇪German Centre for Cardiovascular Research; Center for Stroke Research Berlin; Charité - Universitätsmedizin Berlin
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
Lipoprotein (a) [Lp(a)] harbors atherogenic potential but its role as a risk factor for ischemic stroke remains controversial. We conducted a meta-analysis to determine the relative strength of the association between Lp(a) and ischemic stroke and identify potential subgroup-specific risk differences.
Methods
A systematic search using the MeSH terms "lipoproteins" OR "lipoprotein a" AND "stroke" was performed in PubMed and ScienceDirect for case-control studies from June 2006 and prospective cohort studies from April 2009 until December 20th 2014. Data from eligible papers published before these dates were reviewed and extracted from previous meta-analyses. Studies that assessed the relationship between Lp(a) levels and ischemic stroke and reported generic data-i.e. odds ratio [OR], hazard ratio, or risk ratio [RR]-were eligible for inclusion. Studies that not distinguish between ischemic and hemorrhagic stroke and transient ischemic attack were excluded. Random effects meta-analyses with mixed-effects meta-regression were performed by pooling adjusted OR or RR.
Results
A total of 20 articles comprising 90,904 subjects and 5029 stroke events were eligible for the meta-analysis. Comparing high with low Lp(a) levels, the pooled estimated OR was 1.41 (95% CI, 1.26-1.57) for case-control studies (n = 11) and the pooled estimated RR was 1.29 (95% CI, 1.06-1.58) for prospective studies (n = 9). Sex-specific differences in RR were inconsistent between case-control and prospective studies. Study populations with a mean age of ≤55 years had an increased RR compared to older study populations. Reported Lp(a) contrast levels and ischemic stroke subtype significantly contributed to the heterogeneity observed in the analyses.
Conclusion
Elevated Lp(a) is an independent risk factor for ischemic stroke and may be especially relevant for young stroke patients. Sex-specific risk differences remain conflicting. Further studies in these subgroups may be warranted.
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