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Lipoprotein(a), remote ischemic conditioning, and stroke recurrence in patients with symptomatic intracranial atherosclerotic stenosis

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机构： [1]Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, 100053, China [2]Center for Evidence Based Medicine, Xuanwu Hospital Capital Medical University, Beijing, 100053, China [3]Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Beijing Institute of Brain Disorders, Beijing Advanced Innovation Center for Big Data-based Precision Medicine, Capital Medical University, Beijing, China [4]Department of Neurology and China-America Institute of Neuroscience, Beijing Institute of Geriatrics, Xuanwu Hospital Capital Medical University, Beijing, 100053, China [5]Department of Neurology, Suzhou Municipal Hospital, Su Zhou, 234000, China [6]Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA

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关键词： Lipoprotein(a) Remote ischemic conditioning Stroke Symptomatic intracranial atherosclerotic stenosis

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This study is to determine symptomatic intracranial atherosclerotic stenosis (ICAS), a significant stroke cause with high recurrence risks, by examining the relationship between lipoprotein(a) and ischemic stroke recurrence. Analyzing data from the RICA trial (chronic remote ischemic conditioning in patients with symptomatic ICAS) involving 1286 patients aged 40-80 years across 84 Chinese stroke centers, we found that participants with lipoprotein(a) levels above 17.4 mg/dL experienced markedly higher stroke recurrence rates (adjusted hazard ratio [HR], 1.38; 95 % CI, 1.05-1.80; P = 0.02), with each doubling of lipoprotein(a) increasing recurrent stroke risk by 18 % (adjusted HR, 1.18; 95 % CI, 1.09-1.29; P < 0.001). Notably, among high lipoprotein(a) participants, the remote ischemic conditioning group demonstrated a lower stroke incidence (16.7 %) compared to the control group (22.6 %), suggesting potential therapeutic benefits (adjusted HR, 0.67; 95 % CI, 0.47-0.96; P = 0.03). The study revealed that elevated lipoprotein(a) levels are independently correlated with increased recurrent ischemic stroke risk in patients with symptomatic ICAS, and those with higher lipoprotein(a) levels might derive more clinical advantages from remote ischemic conditioning. Additional research is required to validate these results.Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.

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大类 | 2 区医学

小类 | 1 区药学 2 区临床神经病学 2 区神经科学

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大类 | 2 区医学

小类 | 1 区药学 2 区临床神经病学 2 区神经科学

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第一作者机构： [1]Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, 100053, China

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