A systematic review on the effect of high serum lipoprotein (a) levels on the prognoses of patients with acute ischemic stroke
JIA Yuanyuan1, ZHANG Yuyao1, WANG Tiantian1, MENG Dianhuai2
1. School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu 210000, China; 2. Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, China
Abstract：Objective To clarify the impact of high serum lipoprotein (a) levels on the prognoses of patients with acute ischemic stroke. Methods We searched PubMed, Web of Science, CNKI and Wan-fang database to identify the literatures regarding lipoprotein (a) levels and prognoses of patients with acute ischemic stroke from the establishment of the databases to April 2022 by using subject words combined with free words, and the extracts included authors, year of publication, study population, study types, key outcome indicators and conclusions. Results Fifteen relevant papers were finally enrolled into this study, and then evaluated in terms of functional prognosis, recurrent event, cognitive impairment and deep vein thrombosis. Acute ischemic stroke patients with high serum lipoprotein (a) levels had a poor prognosis in functional impairment, a high risk of recurrence, severer cognitive impairment and a high incidence of deep vein thrombosis. Conclusion Acute ischemic stroke patients with high serum lipoprotein (a) levels have poor prognoses compared with those with the normal level ofserum lipoprotein (a).
贾园园, 张禹遥, 王甜甜, 孟殿怀. 高血清脂蛋白(a)水平对急性缺血性脑卒中患者预后影响系统综述[J]. 实用预防医学, 2024, 31(2): 247-251.
JIA Yuanyuan, ZHANG Yuyao, WANG Tiantian, MENG Dianhuai. A systematic review on the effect of high serum lipoprotein (a) levels on the prognoses of patients with acute ischemic stroke. , 2024, 31(2): 247-251.
[1] Qin H,Chen Y,Liu G,et al. Management characteristics and prognosis after stroke in China: findings from a large nationwide stroke registry[J]. Stroke Vasc Neurol, 2021, 6(1):1-9. [2] Wang W,Jiang B,Sun H,et al. Prevalence, incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480,687 adults[J]. Circulation, 2017, 135(8):759-771. [3] Montellano FA, Ungethum K, Ramiro L, et al. Role of blood-based biomarkers in ischemic stroke prognosis: a systematic review[J]. Stroke, 2021, 52(2):543-551. [4] Dangas G,Mehran R,Harpel PC,et al. Lipoprotein(a) and inflammation in human coronary atheroma: association with the severity of clinical presentation[J]. J Am Coll Cardiol, 1998, 32(7):2035-2042. [5] Youssef A,Clark JR,Marcovina SM,et al. Apo(a) and ApoB interact noncovalently within hepatocytes: implications for regulation of Lp(a) levels by modulation of ApoB secretion[J]. Arterioscl Throm Vas, 2022, 42(3):289-304. [6] Burgess S,Ference BA,Staley JR,et al. Association of LPA variants withrisk of coronary disease and the implications for lipoprotein(a)-lowering therapies: a mendelian randomization analysis[J]. JAMA Cardiol, 2018, 3(7):619-627. [7] Zhang W, Zhang XA. Prognostic value of serum lipoprotein(a) levels in patients with acute ischemic stroke[J]. Neuroreport, 2014, 25(4):262-266. [8] Rawther T, Tabet F. Biology, pathophysiology and current therapies that affect lipoprotein (a) levels[J]. J Mol Cell Cardiol, 2019, 131:1-11. [9] Ramiro L,Simats A,Garcia-Berrocoso T,et al. Inflammatory molecules might become both biomarkers and therapeutic targets for stroke management[J]. Ther Adv Neurol Diso, 2018,11:1-24. [10] Chakraborty B,Vishnoi G,Goswami B,et al. Lipoprotein(a), ferritin, and albumin in acute phase reaction predicts severity and mortality of acute ischemic stroke in North Indian patients[J]. J Stroke Cerebrovasc, 2013, 22(7):159-167. [11] Jiang X,Xu J,Hao X,et al. Elevated lipoprotein(a) and lipoprotein-associated phospholipase A2 are associated with unfavorable functional outcomes in patients with ischemic stroke [J]. J Neuroinflamm, 2021, 18(1):1-8. [12] Han L,Zhong C,Bu X,et al. Prognostic value of lipoprotein-associated phospholipase A2 mass for all-cause mortality and vascular events within one year after acute ischemic stroke[J]. Atherosclerosis, 2017, 266:1-7. [13] 张玉敏. 血清脂蛋白(a)、中性粒细胞与淋巴细胞比值对急性缺血性脑卒中患者短期预后的预测价值 [J]. 中国老年学杂志, 2021,41(15):933-936. [14] 贾淑芬. 急性缺血性脑卒中患者血清脂蛋白(a)水平及临床意义 [J]. 中国康复理论与实践, 2014,20(11):1063-1067. [15] 夏宏林. 脂蛋白A评估缺血性脑卒中患者预后的价值及最佳切点值选择 [J]. 中国老年学杂志, 2019,39(12):2860-2862. [16] Wang H, Zhao J, Gui Y, et al. Elevated lipoprotein (a) and risk of poor functional outcome in Chinese patients with ischemic stroke and type 2 diabetes[J]. Neurotox Res, 2018, 33(4):868-875. [17] 许俊杰, 陆霞, 张林燕, 等. 嘉兴市城南社区2型糖尿病患者并发脑卒中患病状况及影响因素调查分析[J].实用预防医学, 2022, 29(11):1358-1361. [18] 蒋伏平. 血清脂蛋白(a)预测合并2型糖尿病的老年急性缺血性卒中患者的转归 [J]. 国际脑血管病杂志, 2019, 27(3):167-172. [19] Feigin VL,Nguyen G,Cercy K,et al. Global, regional, and country-specific lifetime risks of stroke, 1990 and 2016[J]. N Engl J Med, 2018, 379(25):2429-2437. [20] 钱海燕, 林丽, 许园. 脑卒中康复期患者自我管理知信行现状调查[J]. 实用预防医学, 2023, 30(8):984-987. [21] Arnold M,Schweizer J,Nakas CT,et al. Lipoprotein(a) is associated with large artery atherosclerosis stroke aetiology and stroke recurrence among patients below the age of 60 years: results from the BIOSIGNAL study [J]. Eur Heart J, 2021,42(22):2186-2196. [22] David J, Grainger HLK, James C, et al. Proliferation of human smooth muscle cells promoted by lipoprotein(a) [J]. Science,1993, 6(11):1655-1658. [23] Xu J, Hao X, Zhan R, et al. Effect of lipoprotein(a) on stroke recurrence attenuates at low LDL-C (low-density lipoprotein) and inflammation levels[J]. Stroke, 2022, 53(8):2504-2511. [24] Hong XW, Wu DM, Lu J, et al. Lipoprotein (a) as a predictor of early stroke recurrence in acute ischemic stroke[J]. Mol Neurobiol, 2018, 55(1):718-726. [25] Lange KS, Nave AH, Liman TG, et al. Lipoprotein(a) levels and recurrent vascular events after first ischemic stroke[J]. Stroke, 2017, 48(1):36-42. [26] Lisko I,Kulmala J,Annetorp M,et al. How can dementia and disability be prevented in older adults: where are we today and where are we going?[J]. J Intern Med, 2021, 289(6):807-830. [27] Li JJ, Li SY, Pan YS, et al. Relationship between lipoprotein (a) [Lp(a)] and cognition in different ischemic stroke subtypes[J]. Front Neurol, 2021, 12:736365. [28] Shi Z,Zhang M,Dong X,et al. Serum lipoprotein (a) on postoperative day 3: a strong predictor of portal and/or splenic vein thrombosis in cirrhotic patients with splenectomy[J]. Clin Appl Thromb Hemost, 2020, 26:1-7. [29] Yin D, Shao P, Liu Y. Elevated lipoprotein (a) levels predict deep vein thrombosis in acute ischemic stroke patients[J]. Neuroreport, 2016, 27(1):39-44. [30] Unal E, Mungan S, Bilen S, et al. The effects of lipoprotein(a) and homocysteine on prognosis and risk factors in acute ischemic stroke[J]. Int J Neurosci, 2013, 123(8):532-536. [31] Zhang J, Du R, Peng K, et al. Serum lipoprotein (a) is associated with increased risk of stroke in Chinese adults: a prospective study[J]. Atherosclerosis, 2019, 289:8-13. [32] Warden BA,Minnier J,Watts GF,et al. Impact of PCSK9 inhibitors on plasma lipoprotein(a) concentrations with or without a background of niacin therapy[J]. J Clin Lipidol, 2019, 13(4):580-585. [33] Sabatine MS. PCSK9 inhibitors: clinical evidence and implementation[J]. Nat Rev Cardiol, 2019, 16(3):155-165. [34] Tsimikas S, Karwatowska-Prokopczuk E, Gouni-Berthold I, et al. Lipoprotein(a) reduction in persons with cardiovascular disease [J]. N Engl J Med, 2020, 382(3):244-255. [35] Nissen SE, Wolski K, Balog C, et al. Single ascending dose study of a short interfering RNA targeting lipoprotein(a)production in individuals with elevated plasma lipoprotein(a) levels[J]. JAMA, 2022, 327(17):1679-1687.
2024, Vol. 31 
