Correlation between serum lipoprotein(a) and early neurological deterioration in patients with branch atherosclerotic disease
10.3760/cma.j.issn.1673-4165.2024.11.004
- VernacularTitle:血清脂蛋白(a)与穿支动脉粥样硬化病患者早期神经功能恶化的相关性
- Author:
Jiajie LU
1
;
Jia'nan YAN
;
Pengyu GONG
Author Information
1. 南通大学附属医院神经内科，南通 226000
- Keywords:
Intracranial arteriosclerosis;
Ischemic stroke;
Disease progression;
Lipoprotein(a);
Risk factors;
Predictive value of tests
- From:
International Journal of Cerebrovascular Diseases
2024;32(11):821-826
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the correlation between lipoprotein(a) and early neurological deterioration (END) in patients with branch atherosclerotic disease (BAD).Methods:Patients with BAD admitted to the Affiliated Hospital of Nantong University from January 2024 to September 2024 were included retrospectively. The demographic and baseline clinical data were collected. END was defined as an increase of ≥2 in the National Institutes of Health Stroke Scale (NIHSS) score from baseline within 1 week after onset, including an increase of ≥1 in motor function score. Multivariate logistic regression analysis was used to identify the independent risk factors for END in patients with BAD. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of lipoprotein(a) for END. Results:A total of 214 patients with BAD were enrolled; including 134 males (62.6%), aged 65.60±11.96 years. The median baseline NIHSS score was 3 (interquartile range, 2-5), the median onset-to-door time was 16 hours (interquartile range, 10-24 hours), and the median onset to blood collection time was 25 hours (interquartile range, 20-38 hours). 141 patients (65.89%) had lenticulostriate arteries infarction, and 73 patients (34.11%) had paramedian pontine arteries infarction. 28 patients (13.08%) received intravenous thrombolysis, and 72 (33.64%) experienced END. Univariate analysis showed that there were significant differences in gender composition, baseline NIHSS score, serum lipoprotein(a), and proportion of patients receiving intravenous thrombolysis between the END group and the non-END group (all P<0.05). Multivariate logistic regression analysis showed that higher lipoprotein(a) (odds ratio [ OR] 1.033, 95% confidence interval [ CI] 1.015-1.052; P<0.001) and intravenous thrombolysis ( OR 2.799, 95% CI 1.109-7.065; P=0.029) were the independent risk factors for END in patients with BAD. ROC curve analysis showed that the area under the curve of lipoprotein(a) for predicting END was 0.621 (95% CI 0.54-0.70). The optimal cutoff value was 23.36 mg/dl. The sensitivity and specificity were 45.8% and 76.8%, respectively. Conclusion:Higher lipoprotein(a) is associated with END in patients with BAD, but its predictive value for END is limited.
