Olivieri O, Cappellari M, Turcato G, et al. - In view of the fact that apo CIII (apolipoprotein CIII), a crucial regulator of lipoprotein metabolism, was correlated with increased activity of coagulation factors and thrombin generation and, in turn, with increased risk of thromboembolic events in both arterial and venous districts, researchers systematically checked medical records to ascertain if this could influence the risk of acute ischemic cerebrovascular events in cardiovascular patients. For this investigation, they measured cerebral ischemic events in a cohort of 950 patients (median age 65 with interquartile range, 55–79 years; 30.7% females) with or without angiographically defined coronary artery disease (CAD: 774 CAD and 176 CAD-free, respectively). All individuals, who were enrolled between May 1999 and December 2006, were prospectively pursued until death or July 31, 2018. Ninety-five patients suffered ischemic stroke/transient ischemic attack (TIA) events after a median follow-up of 130 months (interquartile range, 69–189). At enrollment, stroke/TIA patients had higher Apo CIII plasma concentration compared with those without stroke/TIA. Even after adjustment for potential confounders, including gender, age, CAD diagnosis, hypertension, atrial fibrillation, oral anticoagulant treatment, and all plasma lipid parameters, patients with Apo CIII levels above the median value (10.6 mg/dL) showed an ≈2-fold heightened risk of stroke/TIA. In cardiovascular patients, such results indicate that a high Apo CIII plasma concentration can anticipate an enhanced risk of ischemic stroke/TIA.