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33 patients with acute cerebral stroke (21 men and 12 women, averaged age 69.9 +/- 11.2 years) were examined for fluctuations in the level of serum Lp(a) 3, 7, 14, and 28 days after the onset of symptoms. The Lp(a) level was higher (p &lt; 0.05, p &lt; 0.001) on days 7 and 14 than on the day of onset. Higher values were associated with poorer outcomes and with larger abnormal densities on brain CT scans. In 33 of these patients, the apo(a)phenotype was determined. Diluted serum was electrophoresed with SDS-containing gel as a carrier, then transcribed on a nitrocellulose membrane, stained by Western blotting and then sensitizing-stained. The results were evaluated by the method of Utermann et al. Outcome was significantly poorer in patients with a double-band apo(a)phenotype than in those with a single-band (p &lt; 0.05). Those with a double-band had significantly higher mean value of Lp(a), except on the day of onset, than did those with a single-band. Patients with large degrees of electrophoresis had significantly higher values of Lp(a) than did those with small degrees. These data suggest that serial measurement of Lp(a) can be of some value in predicting the outcome in patients with cerebral stroke. Determination of apo(a) phenotype may also be useful in the prevention and prognosis of cerebral stroke, especially when it is caused by cerebral infarction.

Changes in Serum Lp(a) and Apo(a)phenotype in Patients with Acute Cerebral Stroke.