Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory marker associated with atherosclerotic and cardiovascular diseases. This study aimed to explore the association of Lp-PLA2 with carotid intima-media thickness (cIMT) in patients with acute ischemic stroke (AIS) and explore a threshold level to predict the risk of vulnerable plaques. This retrospective observational study included patients with AIS in the Neurology Department of our Hospital between January 2018 and December 2019. The study included 293 patients aged 65.29 ± 12.11 years, including 212 males, of whom 124 had carotid intima-media thickening (42.32%). Multivariable logistic regression showed that Lp-PLA2 level was an independent risk factor for cIMT (odds ratio [OR] = 1.004, 95% confidence interval [95% CI] 1.001–1.008, P = .008). Threshold effect analysis showed that the risk of vulnerable carotid plaque occurrence increased by 2% for every 1 ng/mL increase in Lp-PLA2 level with serum Lp-PLA2 levels between 157 and 279 ng/mL; this increase was statistically significant (OR = 1.02, 95% CI 1.01–1.03, P < .001). Serum Lp-PLA2 is an independent risk factor for increased cIMT in patients with AIS, and a threshold Lp-PLA2 level between 157 and 279 ng/mL showed a higher risk of carotid plaque rupture.

中文翻译：

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急性脑梗死患者脂蛋白相关磷脂酶 A2 与颈动脉内膜中层厚度的关系

脂蛋白相关磷脂酶 A2 (Lp-PLA2) 是一种与动脉粥样硬化和心血管疾病相关的炎症标志物。本研究旨在探讨急性缺血性脑卒中（AIS）患者的Lp-PLA2与颈动脉内膜中层厚度（cIMT）的关系，并探索预测易损斑块风险的阈值水平。本回顾性观察研究纳入了我院神经内科2018年1月至2019年12月期间的AIS患者。研究纳入293例患者，年龄65.29±12.11岁，其中男性212例，其中124例存在颈动脉内膜中层增厚（42.32%） 。多变量逻辑回归显示 Lp-PLA2 水平是 cIMT 的独立危险因素（优势比 [OR] = 1.004，95% 置信区间 [95% CI] 1.001–1.008，P = .008）。阈值效应分析显示，血清Lp-PLA2水平在157～279 ng/mL之间，Lp-PLA2水平每增加1 ng/mL，颈动脉易损斑块发生风险增加2%；这种增加具有统计学意义（OR = 1.02，95% CI 1.01–1.03，P < .001）。血清Lp-PLA2是AIS患者cIMT增加的独立危险因素，阈值Lp-PLA2水平在157至279 ng/mL之间显示颈动脉斑块破裂的风险较高。