Synergetic impact of lipoprotein(a) and fibrinogen on stroke in coronary artery disease patients

Background Emerging data suggested that lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease. Previous studies indicated fibrinogen (Fib) had synergetic effect on Lp(a)‐induced events. However, combined impact of Fib and Lp(a) on ischemic stroke has not been elucidated. Methods In this prospective study, we consecutively enrolled 8263 patients with stable coronary artery diseases (CAD) from 2011 to 2017. Patients were categorized into three groups according to tertiles of Lp(a) levels [Lp(a)‐low, Lp(a)‐medium, and Lp(a)‐high] and further divided into nine groups by Lp(a) and Fib levels. All subjects were followed up for the occurrence of ischemic stroke. Results During a median follow‐up of 37.7 months, 157 (1.9%) ischemic strokes occurred. Stroke incidence increased by Lp(a) (1.1 vs. 2.1 vs. 2.5%, Cochran‐Armitage p