ABSTRACT NUMBER: ESOC2026A1545 LIPOPROTEIN A IN ISCHEMIC STROKE AND MYOCARDIAL INFARCTION: A RETROSPECTIVE SINGLE-CENTER COHORT STUDY

Abstract Background and aims Lipoprotein(a) [Lp(a)] is a genetically determined lipid-related risk factor strongly associated with atherosclerosis, myocardial infarction, and ischaemic stroke. While its role in coronary artery disease is well established, data on the distribution and clinical relevance of Lp(a) in ischaemic stroke and across different vascular disease phenotypes remain limited. This study aimed to characterise Lp(a) concentrations in patients with ischaemic stroke and myocardial infarction and to explore associations with clinical characteristics and disease subtypes. Methods This retrospective, observational, single-centre cohort study analysed routine clinical and laboratory data from a hospital serving as the primary comprehensive stroke and chest pain centre for a catchment area of approximately 450,000 inhabitants. Around 2,800 adult patients with ischaemic stroke, stable coronary artery disease, or acute coronary syndrome were included. Lp(a) concentrations were reported in nm/l. Demographic characteristics, laboratory values and clinical data were extracted from electronic health records. Ischaemic stroke cases were classified according to established aetiological subtypes. The study was registered in the German Clinical Trials Register (DRKS00037499). Results Analyses demonstrated marked interindividual variability in Lp(a) concentrations across cerebrovascular and coronary disease entities, with a substantial proportion of patients exceeding commonly used risk thresholds. Differences in demographic profiles, lipid parameters, and inflammatory markers were observed between stroke and myocardial infarction cohorts. Conclusions This real-world cohort study provides a detailed characterisation of Lp(a) in ischaemic stroke and myocardial infarction and may improve understanding of Lp(a)-associated risk across vascular territories, supporting future risk stratification and preventive strategies. Conflict of interest Lena Weber: nothing to disclose, Vincent Weber: nothing to disclose, Barbara Larcher: nothing to disclose, Benjamin Matosevic: nothing to disclose, Alexander Vonbank: nothing to disclose, Philipp Werner: nothing to disclose, Saju Khan: nothing to disclose