ABSTRACT NUMBER: ESOC2026A1533 LIPOPROTEIN(A) IN DIFFERENT ETIOLOGIES OF ISCHEMIC STROKE: A RETROSPECTIVE SINGLE-CENTER COHORT STUDY

Abstract Background and aims Lipoprotein(a) [Lp(a)] is a genetically determined plasma lipoprotein and an established independent risk factor for atherosclerosis and cardiovascular disease. Elevated Lp(a) levels are associated with an increased risk of ischemic stroke. While its role in coronary artery disease is well established, data on the distribution and clinical relevance of Lp(a) in ischemic stroke, particularly in Caucasian populations, remain limited. This study aimed to characterise Lp(a) concentrations across different ischemic stroke etiologies, with a focus on large artery atherosclerosis. Methods This retrospective, observational, single-center cohort study analysed routine clinical and laboratory data from a comprehensive stroke center serving approximately 450,000 inhabitants. Lp(a) measurements were available in about 600 patients as part of routine care. Data were extracted from institutional laboratory databases and electronic health records and included demographic variables, laboratory parameters, and established cardiovascular risk factors. No additional blood sampling or interventions were performed. All data were anonymized. Lp(a) concentrations were reported in nmol/L. The study was registered in the German Clinical Trials Register (DRKS00037499). Results Lp(a) concentrations showed variability across ischemic stroke etiologies, with a considerable proportion of patients exceeding commonly used risk thresholds. Differences in demographic characteristics, lipid profiles, and inflammatory markers were observed between subgroups. Multivariable regression and subgroup analyses evaluating associations between Lp(a), clinical characteristics, and ultrasound findings are ongoing. Conclusions This real-world cohort study provides a detailed characterisation of Lp(a) across stroke subtypes and may support improved risk stratification and preventive strategies in patients with large artery atherosclerosis. 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