Key result
Elevated baseline Lp(a) is linked to ~81% higher stroke risk in postmenopausal women.
Why the study?
Although Lp(a) is an established atherosclerotic cardiovascular risk factor, its association with stroke is less consistent than with coronary disease and appears to depend on stroke subtype and the degree of Lp(a) elevation.
Does elevated baseline lipoprotein(a) increase the risk of incident total stroke in postmenopausal Taiwanese women?
Cohort (n=1,113)
No
Does elevated baseline lipoprotein(a) increase the risk of incident total stroke in postmenopausal Taiwanese women?
In postmenopausal Taiwanese women, baseline Lp(a) levels at or above the 75th and 90th cohort percentiles were significantly associated with an increased risk of incident total stroke over 8.6 years, providing hypothesis-generating evidence in an underrepresented East Asian population.
Lipoprotein(a) [Lp(a)] is an established atherosclerotic cardiovascular risk factor, but its association with stroke is less consistent than that with coronary disease and appears to depend on stroke subtype and the degree of Lp(a) elevation. We examined whether baseline Lp(a) was associated with incident total stroke in 1113 Taiwanese women who met an amenorrhea-based definition of postmenopausal status in the Chin-Shan Community Cardiovascular Cohort. Because contemporary data suggest that Lp(a)-related stroke risk is most evident for ischemic stroke and at very high concentrations, cohort-specific 75th (20.05 mg/dL) and 90th (36.55 mg/dL) percentiles were treated as internal exposure rankings rather than clinical cutoffs. During a mean follow-up of 8.6 years, 55 total strokes and 25 coronary artery disease (CAD) events occurred. After adjustment for age, body mass index, hypertension, diabetes mellitus, smoking, LDL cholesterol, and triglycerides, Lp(a) ≥ 75th percentile was associated with total stroke (HR 1.81, 95% CI 1.02–3.21; p = 0.04), with a higher point estimate at ≥90th percentile (HR 2.45, 95% CI 1.26–4.76; p = 0.01). CAD estimates were imprecise and not statistically significant. These findings provide hypothesis-generating risk-marker evidence from an underrepresented East Asian population but do not establish ischemic-stroke specificity, a menopause-specific mechanism, a lower clinical Lp(a) threshold, or a stronger association with stroke than CAD.
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Wu et al. (2026) conducted a cohort in Incident total stroke in postmenopausal women (n=1,113). Baseline Lipoprotein(a) [Lp(a)] ≥75th percentile (20.05 mg/dL) and ≥90th percentile (36.55 mg/dL) vs. Lower Lp(a) percentiles (<75th or <90th percentile) was evaluated on Incident total stroke (HR 1.81, 95% CI 1.02-3.21, p=0.04). Baseline Lp(a) ≥75th percentile was associated with incident total stroke in postmenopausal Taiwanese women (HR 1.81, 95% CI 1.02-3.21; p=0.04; ≥90th percentile HR 2.45, 95% CI 1.26-4.76; p=0.01).
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