Clinical Study on the Association Between Lipoprotein(a) Levels and Prognosis in Patients With Acute Ischemic Stroke

BACKGROUND: Lipoprotein(a) (Lp(a)) is a known cardiovascular risk factor, but its role in acute ischemic stroke (AIS) prognosis remains unclear. This study investigated the association between Lp(a) levels and 3-month functional outcomes in AIS patients. METHODS: We conducted a retrospective cohort study of 175 AIS patients. Prognosis was assessed using the 3-month modified Rankin Scale (mRS > 2 defined as poor). Logistic regression and threshold effect models analyzed the association, while ROC curves compared the predictive performance of Lp(a) and NIHSS scores. RESULTS: Elevated Lp(a) was an independent risk factor for poor 3-month prognosis (OR = 1.09, p = 0.004). A significant threshold effect was identified at 31.2 mg/dL, above which the risk of poor outcomes increased by 79% (p = 0.0398). Combining Lp(a) with admission NIHSS scores yielded a significantly higher AUC (0.6820) and specificity (0.9208) than either indicator alone. Sensitivity analyses confirmed the robustness of these findings. CONCLUSION: Lp(a) is a stable and independent predictor of poor 3-month outcomes in AIS patients, exhibiting a clear threshold effect at 31.2 mg/dL. The combined Lp(a)-NIHSS model enhances prognostic accuracy, supporting Lp(a) as a valuable biomarker for early risk stratification.