Abstract Introduction Lp(a) is an independent risk factor for a variety of cardiovascular (CV) outcomes. However, it remains unclear whether its prognostic value differs between individuals with varying baseline traditional CV risk. This study aims to evaluate the association between Lp(a) levels and all-cause 50 mg/dL) was present in 15% overall, more commonly in the high-risk group (15% vs 11% in low-risk). In the high-risk group, Lp(a) 75 mg/dL was associated with higher all-cause (HR: 1.25; 95% CI: 1.02–1.53) and CV mortality (sHR: 1.21; 95% CI: 1.09–1.36). Lp(a) 50–75 mg/dL showed a borderline association with all-cause mortality (HR: 1.16; 95% CI: 1.00–1.34) but not CV mortality (sHR: 1.06; 95% CI: 0.98–1.15). No significant associations were observed in lower-risk groups. Conclusions Elevated Lp(a) levels ( 75 mg/dL) are associated with increased all-cause and CV mortality among individuals with high baseline traditional CV risk, as defined by the AHA's PREVENT score, independent of traditional risk factors. Our findings highlight the value of Lp(a) particularly among those with elevated baseline risk, where its prognostic utility appears greatest.
Al-Jarshawi et al. (Tue,) studied this question.
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