July 15, 2026Journal of the American College of Cardiology
Elevated Lipoprotein(a) and Risk of Ischemic Stroke
Key result
High Lp(a) levels linked to ~60% higher ischemic stroke risk versus low levels.
- HR 1.60
- 95% CI 1.24 to 2.05
- n=60,512
Why the study?
Is high lipoprotein(a) associated with an increased risk of ischemic stroke in the general population?
Population
60,512 individuals from the general population with measurements of plasma lipoprotein and genetic variants.
Comparison
High lipoprotein levels and genetic variants vs Lipoprotein levels <10 mg/dl
Design
Cohort
Authors
Discussion
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Implication
High plasma levels of lipoprotein(a) are observationally and causally associated with an increased risk of ischemic stroke in the general population.
Key Points
- This study aims to explore the relationship between high lipoprotein(a) levels and the risk of ischemic stroke, using both observational data and genetic analysis.
- Included 49,699 individuals from the Copenhagen General Population Study and 10,813 from the Copenhagen City Heart Study.
- Measured plasma lipoprotein(a) levels and genetic variants like LPA kringle-IV type 2 number of repeats and LPA rs10455872.
- Ascertainment of ischemic stroke was done through Danish national health registries validated by medical doctors.
- Individuals with lipoprotein(a) levels >93 mg/dl had a multivariable-adjusted hazard ratio of 1.60 for ischemic stroke (95% CI: 1.24 to 2.05).
- A 50 mg/dl increase in lipoprotein(a) was associated with a hazard ratio of 1.20 for ischemic stroke (95% CI: 1.13 to 1.28).
- In smokers >70 years with hypertension and high lipoprotein(a), the 10-year risk of ischemic stroke was 17%.
Study Design
Type
Cohort (n=60,512)
Multicenter
Yes
Structured PICO
Is high lipoprotein(a) associated with an increased risk of ischemic stroke in the general population?
P
Population
60,512 individuals from two Danish population cohorts with measurements of plasma lipoprotein(a) and genetic variants, evaluated for the risk of ischemic stroke.
E
Exposure
High lipoprotein(a) levels (>93 mg/dl or >199 nmol/L: 96th to 100th percentile) and genetic variants (LPA kringle-IV type 2 number of repeats, and LPA rs10455872)
C
Comparator
Lipoprotein(a) levels <10 mg/dl (<18 nmol/l: first to 50th percentile)
O
Outcome
Ischemic stroke ascertained from Danish national health registries and validated by medical doctorshard clinical
Main Result
Hazard Ratio: 1.6 (95% CI 1.24–2.05)
High plasma levels of lipoprotein(a) are observationally and causally associated with an increased risk of ischemic stroke in the general population.
Cite This Study
Langsted et al. (2019) conducted a cohort in Ischemic stroke (n=60,512). Elevated lipoprotein(a) vs. Lipoprotein(a) levels <10 mg/dl (first to 50th percentile) was evaluated on Ischemic stroke (HR 1.60, 95% CI 1.24 to 2.05). High plasma levels of lipoprotein(a) (>93 mg/dl) were associated with an increased risk of ischemic stroke compared to levels <10 mg/dl (HR 1.60; 95% CI 1.24 to 2.05).