Association Between Lipoprotein(a) Levels and Recurrent Ischemic Stroke in Young Adults (<50 Years): A Prospective Cohort Analysis

Resumen

Background: Lipoprotein(a) [Lp(a)] is a genetically determined lipid particle with pro-atherogenic and pro-thrombotic properties. Emerging evidence suggests its role in ischemic stroke, particularly among younger populations, but its association with recurrent stroke remains inadequately explored.

Objective: To evaluate the association between elevated Lp(a) levels and the risk of recurrent ischemic stroke in young adults (<50 years).

Methods: A prospective cohort study was conducted including young adults diagnosed with first-ever ischemic stroke. Baseline Lp(a) levels were measured and categorized using clinically relevant thresholds. Patients were followed for recurrent cerebrovascular events over 12–24 months. Multivariate Cox regression analysis was used to assess the independent association between elevated Lp(a) and recurrence risk.

Results: Elevated Lp(a) levels were significantly associated with an increased risk of recurrent ischemic stroke. Patients with Lp(a) ≥100 nmol/L demonstrated higher recurrence rates compared to those with lower levels. The association remained significant after adjustment for traditional vascular risk factors. Subgroup analysis indicated a stronger association in patients with large artery atherosclerosis.

Conclusions: High Lp(a) levels are an independent predictor of recurrent ischemic stroke in young adults. Routine screening of Lp(a) in young stroke patients may improve risk stratification and guide secondary prevention strategies.