Lp-PLA₂ as a risk factor of early neurological deterioration in acute ischemic stroke with TOAST type of large arterial atherosclerosis

ABSTRACT

Introduction: Lipoprotein-associated phospholipase A₂ (Lp-PLA₂) is a well-known risk factor of atherosclerotic vascular diseases. Nevertheless, its role in the acute phase of ischemic stroke is still unclear. The aim of this study is to identify the relationship between Lp-PLA₂ levels and early neurological deterioration (END) in acute ischemic stroke patients with Trial of Org 10 172 in Acute Stroke Treatment (TOAST) subtype of large arterial atherosclerosis (LAA).

Methods: We enrolled Chinese patients with first ever acute ischemic stroke admitted to Neurology Department of Shenzhen Second People’s Hospital within 48 h from onset of symptoms during January – November 2015. Demographic and laboratory information were collected while END was defined as an increase in the National Institute of Health Stroke Scale score by ≥ 1 point in motor power, or ≥ 2 points in the total score within 10 days after admission.

Results: Overall 181 patients were involved; END was diagnosed in 30 patients within 10 days after admission. The odds ratio for END increased with increasing levels of Lp-PLA₂ (intermediate level, OR = 1.96, 95%CI 1.02–4.27, p = 0.041; high level, OR = 2.99, 95%CI 1.26–5.73, p = 0.023).

Conclution: Intermediate and high level of Lp-PLA₂ was identified as independent predictor of END in multivariate analysis. Lp-PLA₂ could be valued as a risk factor of END in patients with acute ischemic stroke with TOAST subtype of LAA.

KEYWORDS:

• Lp-PLA2 concentration
• early neurological deterioration (END)
• acute ischemic stroke
• TOAST
• large arterial atherosclerosis (LAA)

Acknowledgments

This work is supported by the Scientific Research Items of Shenzhen Science and Technology Innovation Committee (No.JCYJ20140414170821253 and JCYJ20151030151431727)

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Scientific Research Items of Shenzhen Science and Technology Innovation Committee [JCYJ20151030151431727 and JCYJ20140414170821253].

Notes on contributors

Yang Wang

Lijie Ren and Yang Wang* conceived and designed the study. Zhihao Lei, Yang Wang, Shiyu Hu* performed the neurological status assessment of each participant. Zhihao Lei, Jingjing Cai and Tao Lan assessed the Lp-PLA2 mass concentration. Yang Wang, Shiyu Hu performed the data collection and paper writing. Lijie Ren, Yang Wang, Shiyu Hu and Chao Li reviewed and edited the manuscript. All authors read and approved the manuscript.*Yang Wang and Shiyu Hu contributed equally to this work.