Lp(a) is a risk factor of coronary heart disease, but its effects on stroke are less well-defined.

A single-center, retrospective case-control study was performed in 1953 ischemic stroke and 196 hemorrhagic stroke in-hospital patients. Controls were selected from healthy subjects and were matched for sex and age (±5 years) for the ischemic stroke (1:1 ratio) and hemorrhagic groups (1:2 ratio) respectively. Lp(a) levels were measured by the latex agglutination turbidimetric method. Logarithmic transformation and quartile categorization were applied for the skewed distribution of Lp(a).

The median Lp(a) level was greater among cases than controls (12.2mg/dL vs. 8.60mg/dL and 14.40 mg/dL vs. 13.40 mg/dL for ischemic and hemorrhagic strokes, respectively). In conditional multivariate analysis, Lp(a) levels showed a positive association with ischemic stroke after adjustment for continuous variables (OR: 1.53, 95% CI: 1.24-1.89) and comparing the highest quartile to the lowest (OR: 1.87, 95% CI: 1.39-2.52). A significant association between elevated log-transformed Lp(a) and ischemic stroke was only seen in men (p < 0.001). Younger patients showed a higher ischemic stroke risk than older patients without a significant interaction (p = 0.157). The elevated Lp(a) level also significantly associated with an increased hemorrhagic stroke risk after adjustment (OR: 1.62, 95% CI: 1.09-2.43). Similar trends were observed in subgroup analyses by age and gender for hemorrhagic stroke.

Elevated serum Lp(a) concentration is positively and significantly correlated with the risks of both ischemic and hemorrhagic stroke in the Chinese Han population, especially among men and younger people.