Serum Lipoprotein(a) and Hemorrhagic stroke risk: A systematic review and meta-analysis.
Maria-Ioanna Stefanou, Evangelos Panagiotopoulos, Aikaterini Theodorou et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the relationship between serum lipoprotein(a) [Lp(a)] levels and hemorrhagic stroke risk in adults. The analysis included eight studies with 526,909 participants and found that while post-event studies indicated higher Lp(a) levels in hemorrhagic stroke cases (SMD, 0.32), prospective cohort studies showed no significant association (pooled HR, 0.88).
Key findings
- Three studies reported higher Lp(a) levels in hemorrhagic stroke compared to healthy controls (SMD, 0.32; 95% CI, 0.18-0.47).
- Two case-control studies indicated greater odds of hemorrhagic stroke (pooled OR, 1.72; 95% CI, 1.31-2.27).
- Four prospective cohort studies showed no significant association with hemorrhagic stroke (pooled HR, 0.88; 95% CI, 0.67-1.14).
- Exploratory analysis combining OR and HR estimates showed no significant association (1.06; 95% CI, 0.80-1.40).
Why it matters
Understanding the relationship between Lp(a) levels and hemorrhagic stroke risk is crucial for risk assessment and management strategies in patients, particularly given the conflicting evidence from different study designs.
What to keep in mind
The evidence from post-event studies is at serious risk of bias, limiting the reliability of the findings.