Is There a Need for Sex‐Tailored Lipoprotein(a) Cut‐Off Values for Coronary Artery Disease Risk Stratification?

Background Lipoprotein(a) [Lp(a)] plasma level is a well‐known risk factor for coronary artery disease (CAD). Existing data regarding the influence of sex on the Lp(a)‐CAD relationship are inconsistent. Objective To investigate the relationship between Lp(a) and CAD in men and women and to elucidate any sex‐specific differences that may exist. Methods Data of patients with Lp(a) measurements who were admitted to a tertiary university hospital, Koc University Hospital, were analyzed. The relationship between Lp(a) levels and CAD was explored in all patients and in subgroups created by sex. Two commonly accepted Lp(a) thresholds ≥ 30 and ≥ 50 mg/dL were analyzed. Results A total of 1858 patients (mean age 54 ± 17 years; 53.33% females) were included in the analysis. Lp(a) was an independent predictor of CAD according to the multivariate regression model for the entire cohort. In all cohort, both cut‐off values (≥ 30 and ≥ 50 mg/dL) were detected as independent predictors of CAD ( p < 0.001). In sex‐specific analysis, an Lp(a) ≥ 30 mg/dL was an independent predictor of CAD only in women ( p < 0.001), but Lp(a) ≥ 50 mg/dL was a CAD predictor both in men and women (men, p = 0.004; women, p = 0.047). Conclusion The findings of this study may suggest that different thresholds of Lp(a) level can be employed for risk stratification in women compared to men.