Lipoprotein(a) and ischemic cerebrovascular disease in young adults.

Serum lipoprotein(a) level is genetically determined and remains almost constant throughout life. Based on this property, we investigated the serum lipoprotein(a) levels of ischemic stroke patients in the chronic stage (mean period after stroke, 27 months) and its relation to the types of ischemic stroke. We measured serum lipoprotein(a) levels in 101 patients with chronic ischemic stroke and 37 normal control subjects, taking the clinical profiles into consideration. Lipoprotein(a) levels in patients with atherothrombotic stroke were 28.0 +/- 19.6 mg/dL (mean +/- SD), which were significantly (P < .01) higher than those in patients with lacunar stroke and in normal control subjects (16.4 +/- 13.5 and 11.7 +/- 10.5 mg/dL, respectively). The lipoprotein(a) levels in patients with atherothrombotic stroke were significantly higher in the subgroup who were a younger age at onset: onset before age 50 years, 35.3 +/- 20.5; onset at age 50 to 59, 35.4 +/- 21.7; onset at age 60 to 69, 17.0 +/- 12.8; and onset at age 70 or older, 16.3 +/- 6.8 mg/dL (P < .01 for onset before age 50 versus 60 to 69 years or 70 years or older; P < .01 for onset at 50 to 59 years versus 60 to 69 years or 70 years or older). Serum lipoprotein(a) was significantly increased (40.2 +/- 20.1 mg/dL) in young adults with atherothrombotic stroke (onset at younger than age 45 years) compared with that in patients older than 45 years (P < .01). We conclude that lipoprotein(a) is a genetic, independent, and critical risk factor for ischemic stroke, especially in young adults.