The Correlation Between Lipoprotein(a) and Cognitive Impairment in Patients With Ischemic Stroke

<b>Aims/Background</b> Lipoprotein(a) [Lp(a)] has been implicated in cerebrovascular diseases and may contribute to cognitive decline. Thus, this study sought to assess cognitive impairment in ischemic stroke patients and its association with Lp(a). <b>Methods</b> This single-center cross-sectional study included 790 patients from the Affiliated Hospital of Xuzhou Medical University between January 2017 and December 2023, categorized into lower and higher Lp(a) groups based on the median Lp(a) levels. Logistic regression analysis, subgroup analysis, sensitivity analysis, receiver operating characteristic (ROC) curve analysis, and restricted cubic spline (RCS) analysis were conducted to explore the association between Lp(a) and cognitive impairment. <b>Results</b> The higher Lp(a) group showed a greater prevalence of cognitive impairment than the lower Lp(a) group (<i>p</i> < 0.001). After accounting for all potential influences, the risk of cognitive impairment was 1.735 times higher in the higher Lp(a) group than in the lower Lp(a) group (<i>p</i> = 0.001), and for each unit increase in Lp(a), the risk of cognitive impairment increased by 0.1% (<i>p</i> = 0.001). Subgroup analysis indicated that the significant association between Lp(a) and cognitive impairment remained stable in all subgroups except for the subgroup without hypertension (<i>p</i> < 0.05). Additionally, even after omitting those with prior stroke, higher Lp(a) levels remained independently linked to an increased risk of cognitive impairment (<i>p</i> < 0.05). ROC analysis revealed that Lp(a) had predictive value for cognitive impairment in the overall population, as well as in male and female patients (<i>p</i> < 0.05). In the multivariate-adjusted regression model, a linear relationship between Lp(a) and cognitive impairment risk was demonstrated by RCS analysis (<i>p</i> < 0.001, <i>p</i> nonlinear = 0.828). <b>Conclusion</b> Higher levels of Lp(a) are independently linked to a greater risk of cognitive impairment in stroke patients.