Case-control study of serum lipoprotein(a) and apolipoproteins A-I and B in stroke in the young

Objectives - Abnormalities of lipoprotein(a) and apolipoproteins A-I and B are being recognised as independent risk factors in ischaemic heart disease and atherosclerosis. There are no studies from India where stroke in the young constitutes nearly 20-30% of all strokes. Subjects and methods - Fasting serum lipids, lipoproteins, apolipoproteins A-I and B and lipoprotein(a) were measured in 50 patients aged less than 40 years presenting with completed stroke and 50 normal, age and sex-matched control subjects. Apolipoproteins A-I and B were measured by immunoturbidimetry and lipoprotein(a) by enzyme-linked immunosorbent assay. Results - The serum total cholesterol, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, triglycerides and apolipoproteins A-I and B were not significantly different in the test group as compared to the controls. However, serum lipoprotein(a) was significantly higher in the young stroke patients. Conclusion - These findings confirm the hypothesis that an elevated serum lipoprotein(a) level is an important risk factor in the development of cerebral ischaemia in patients aged less than 40 years It may be worthwhile to study whether it is useful in identifying patients most at risk for stroke.