Context: Lipoprotein (a) is an established risk factor for coronary artery disease but its role as a risk factor for stroke is not established. Aims: To estimate the prevalence of elevated levels of lipoprotein (a) in young patients (18-55 years) with ischemic stroke and to study the association between lipoprotein (a) plasma concentration and carotid atherosclerosis Settings and Design: This observational, cross-sectional, single center study was conductedon 90 young (18-55 years) patients with imaging confirmed ischemic stroke for a duration of 1 year. Lipoprotein (a) samples were taken within 24 hours of presentation to the hospital and values >30mg/dL were considered abnormal. Carotid Doppler was done by a cardiologist unaware of history of patientsl. Patients were divided into two groups: Group A (normal) and Group B (abnormal). Average values of lipoprotein (a) levels in both the groups were taken and compared using appropriate statistical analysis. Results: There were 65 males and 25 females in the study. Prevalence of elevated lipoprotein (a) in the study population was found to be 44.4%. It was more than the other traditional risk factors for stroke. Prevalence of carotid atherosclerosis and carotid stenosis in the study was 41.1% and 31.1% respectively. Elevation of lipoprotein (a) was strongly associated with carotid atherosclerosis (p=0.001). Mean values of lipoprotein (a) were statistically higher in the atherosclerosis group than in no atherosclerosis group (p=0.002). Lipoprotein (a) was positively associated with carotid stenosis in a graded manner but its association with CIMT was not significant. The association of lipoprotein (a) and carotid atherosclerosis was independent of other risk factors.

Conclusion: Lipoprotein (a) is strongly associated with carotid atherosclerosis (especially carotid stenosis) in young patients with ischemic stroke and the association is independent of the traditional risk factors. 

Keywords: Ischemic Stroke; Young Population; Lipoprotein (a); Carotid Atherosclerosis.