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Relation between lipoprotein-associated phospholipase A2 mass and incident ischemic stroke severity

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Abstract

Background

Manifestations of ischemic stroke vary widely, and serum biomarkers may be useful for stratification of risk of severe stroke. This study evaluated the association of lipoprotein-associated phospholipase A2 (Lp-PLA2) mass and initial severity.

Methods

We employed a retrospective analysis on our hospital-based registry and recruited 488 first-onset ischemic stroke patients admitted within 24 h after onset and with Lp-PLA2 mass measured. Stroke severities evaluated by National Institutes of Health Stroke Scale (NIHSS) were compared between Lp-PLA2 categories dichotomized by median. Multivariate logistic regression was used to detect the independent risk factors of severe stroke (NIHSS ≥ 7) and receiver operator curve (ROC) was constructed to detect the value of addition of Lp-PLA2 to the model of other risk factors for predicting severe stroke.

Results

Of the overall patients, the median admission NIHSS scores was 3 and 28.1% had severe manifestation. Admission NIHSS scores were different between patients of Lp-PLA2 above and under the median (median NIHSS 4 vs. 3, P < 0.001). Lp-PLA2 levels was correlated with admission NIHSS (r = 0.268, P < 0.001). Logistic regression showed Lp-PLA2 category (OR 2.37, 95%CI 1.44–3.90, P < 0.001) and levels per 100 ng/ml (OR 1.69, 95%CI 1.35–2.11, P < 0.001) were both independently associated with severe stroke. Addition of Lp-PLA2 category and levels to other independent risk factors both increased the area under curves (from 0.676 to 0.718 with category and 0.734 with levels).

Conclusion

Lp-PLA2 was independently related to admission severity in ischemic stroke patients, implying a potential predictive value of Lp-PLA2 for severe stroke in prevention.

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Authors and Affiliations

  1. Nanjing First Hospital, Nanjing Medical University, Nanjing, China

    Feng Zhou, Yukai Liu, Hongchao Shi, Qing Huang & Junshan Zhou

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  1. Feng Zhou
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  2. Yukai Liu
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  3. Hongchao Shi
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  4. Qing Huang
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  5. Junshan Zhou
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Correspondence to Junshan Zhou.

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Zhou, F., Liu, Y., Shi, H. et al. Relation between lipoprotein-associated phospholipase A2 mass and incident ischemic stroke severity. Neurol Sci 39, 1591–1596 (2018). https://doi.org/10.1007/s10072-018-3474-3

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  • DOI: https://doi.org/10.1007/s10072-018-3474-3

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