Elevated Lp(a) (≥125nmol/L) was found in 18.9% of patients and associated with 67% higher risk of major adverse cardiovascular events (HR 1.67, p=0.01).
Does elevated Lp(a) increase the risk of adverse cardiovascular events and atherosclerosis burden in patients with and without established ASCVD?
In a Greek lipid clinic cohort, elevated Lp(a) ≥125 nmol/L was present in nearly 20% of patients and was significantly associated with increased atherosclerosis burden and a 1.67-fold higher risk of major adverse cardiovascular events.
Tasa de eventos absoluta: 0% vs 0%
Abstract Background Lp(a) has emerged as a promising biomarker for atherosclerotic cardiovascular disease (ASCVD). However, epidemiologic data and associations with markers of subclinical ASCVD and ASCVD outcomes in Greece remain scarce. Methods We included consecutively recruited patients assessed in a tertiary outpatients lipid clinic with and without ASCVD and available Lp(a) levels (n=1,106). Vascular markers of interest included ultrasonographic carotid and femoral wall thickness, carotid-femoral pulse wave velocity (PWV) and ankle-branchial index (ABI). ASCVD outcome was defined as all cause death, non-fatal myocardial infarction and coronary revascularization across a median follow-up of 23.8 months. Results Among study participants, 18.9% presented with increased Lp(a) (≥125nmol/L) (16.0% without and 22.1% with established ASCVD, p=0.011). Participants with increased Lp(a) levels had higher prevalence of female sex, dyslipidemia, lipid-lowering treatment, family history of ASCVD and lower BMI (p0.05 for all). Elevated Lp(a) levels were associated with increased burden, extent and severity of carotid and coronary artery and lower extremity atherosclerosis (p0.05 for all). Finally, Lp(a) levels were associated with increased risk for MACE (log-rank=0.028, adjusted HR: 1.67 95% CI: 1.12-2.91 in Lp(a) ≥125nmol/L vs. Lp(a)125nmol/L, p=0.01) If Lp(a) was used as risk enhancer in primary prevention, 20.6% would be eligible for drug interventions to reduce residual risk. Conclusion In a Greek population from a tertiary outpatients’ lipid clinic, we report comparable to other European countries prevalence of increased Lp(a) levels. This subgroup of patients presented increased atherosclerosis burden and risk for adverse cardiovascular events. This data may inform national healthcare policies and refine indications for new developing treatments
Delialis et al. (Sat,) reported a other. Elevated Lp(a) (≥125nmol/L) was found in 18.9% of patients and associated with 67% higher risk of major adverse cardiovascular events (HR 1.67, p=0.01).