Patients with Lp(a) ≥200 nmol/L exhibited significantly higher platelet activity compared to those with Lp(a) <200 nmol/L (PL-AUC 255.9 vs 144.4; p=0.0468).
Observational (n=56)
Does elevated Lp(a) (≥200 nmol/L) increase platelet activity and reduce ASA responsiveness in patients at very high cardiovascular risk?
Elevated Lp(a) ≥200 nmol/L in very high cardiovascular risk patients is associated with increased platelet activity, higher coagulation parameters, and more frequent non-responsiveness to aspirin.
Absolute Event Rate: 255.9% vs 144.4%
p-value: p=0.0468
Abstract Lp(a) concentrations exceeding 200 nmol/L are associated with more than a 2–3-fold increase in the risk of myocardial infarction. Lipoprotein(a) may potentiate platelet activation and influence the coagulation system. Elevated Lp(a) levels may also diminish the effectiveness of antiplatelet therapy. The aim of the study was to assess platelet activity, coagulation parameters, and the response to acetylsalicylic acid (ASA) using the T-TAS®01 system in patients with very high cardiovascular risk, stratified according to Lp(a) concentration. A total of 56 patients on chronic ASA therapy were enrolled. Hemostatic assessment was performed using the T-TAS®01 system. Additionally, LDL, Lp(a), fibrinogen levels, and von Willebrand factor (vWF) activity were measured. Non-responsiveness to ASA was defined as PL-AUC 304.9. An adequate response to ASA (ASA+) was observed in 41 patients (73.2%), including 14 individuals with Lp(a) ≥200 nmol/L (34%). Lack of response to ASA (ASA–) was noted in 15 patients (26.9%), including 6 with Lp(a) ≥200 nmol/L (40%). In the Lp(a) ≥200 nmol/L group, vWF activity was significantly higher (140.5 103.4–189.8 vs 107.8 99.3–127.3, p=0.0333), as were fibrinogen concentrations (314.2±53.94 vs 282.2±58.46, p=0.0474), compared with patients with Lp(a) 200 nmol/L. Patients with Lp(a) 200 nmol/L had lower PL-AUC values compared with those with Lp(a) ≥200 nmol/L (144.4 32–274.1 vs 255.9 159.5–312.3, p=0.0468). Patients with Lp(a) ≥200 nmol/L more frequently demonstrated ASA non-responsiveness, as well as higher vWF activity and fibrinogen levels, compared with those with lower Lp(a). Moreover, this group exhibited higher PL-AUC values, indicating increased platelet activity.
Jeziorska et al. (Fri,) conducted a observational in very high cardiovascular risk (n=56). Lp(a) ≥200 nmol/L vs. Lp(a) <200 nmol/L was evaluated on Platelet activity (PL-AUC) (p=0.0468). Patients with Lp(a) ≥200 nmol/L exhibited significantly higher platelet activity compared to those with Lp(a) <200 nmol/L (PL-AUC 255.9 vs 144.4; p=0.0468).