What is the clinical evidence from this study?

Study design: Cohort. Population: Premature ASCVD (n=2684). Intervention: Elevated lipoprotein(a) (≥150 nmol/L) vs. Lipoprotein(a) <65 nmol/L. Primary outcome: MACE (composite of MI, ischemic stroke, coronary revascularization, and all-cause death) (HR 1.20, p=<0.05).

What question did this study set out to answer?

This study aims to assess the prevalence of elevated lipoprotein(a) and its link to major adverse cardiovascular events in young ASCVD patients.

February 8, 2026European Heart Journal

Prevalence of elevated lipoprotein(a) in premature ASCVD patients and its association with major adverse cardiovascular events: analysis of a large US electronic health record database

Q: What are the key findings of this study?

In patients with premature ASCVD, elevated lipoprotein(a) ≥150 nmol/L was associated with a 20% greater risk of MACE compared to levels <65 nmol/L (HR 1.20, p<0.05).

Q: What question did this study set out to answer?

This study aims to assess the prevalence of elevated lipoprotein(a) and its link to major adverse cardiovascular events in young ASCVD patients.

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Key result

Elevated Lp(a) is linked to ~20% higher MACE risk in premature ASCVD.

HR 1.20
P<0.05
n=2,684

Why the study?

Does elevated Lp(a) (≥150 nmol/L) increase the risk of MACE in premature ASCVD patients compared to Lp(a) <65 nmol/L?

Key Points

This study aims to assess the prevalence of elevated lipoprotein(a) and its link to major adverse cardiovascular events in young ASCVD patients.
Conducted a retrospective cohort analysis using Optum EHR data from January 2014 to June 2023.
Included adult premature ASCVD patients with measured lipoprotein(a) levels in nmol/L.
Defined premature ASCVD based on age-related myocardial infarction, stroke, or peripheral artery disease.
Calculated incidence rates, incidence rate ratios, and hazard ratios for cardiovascular events, controlling for age and sex.
Identified 2,684 premature ASCVD patients, with 29.7% having elevated lipoprotein(a) ≥125 nmol/L and 25.3% ≥150 nmol/L.
Over 3.75 years, 38.8% experienced a subsequent major adverse cardiovascular event.
Individuals with lipoprotein(a) ≥150 nmol/L had a significantly increased risk of MACE (42.7%) and higher rates of myocardial infarction and coronary revascularization.

Study Design

Type

Cohort (n=2,684)

Multicenter

Yes

Structured PICO

Does elevated Lp(a) (≥150 nmol/L) increase the risk of MACE in premature ASCVD patients compared to Lp(a) <65 nmol/L?

Population

2,684 adult patients with premature ASCVD and an available Lp(a) measurement, followed for a median of 3.75 years.

Exposure

Elevated Lipoprotein(a) (Lp(a) ≥150 nmol/L)

Comparator

Lipoprotein(a) <65 nmol/L

Outcome

MACE (composite of MI, ischemic stroke, coronary revascularization, and all-cause death)composite

Main Result

Hazard Ratio: 1.2

p-value: p=<0.05

Discussion

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Implication

Elevated Lp(a) ≥150 nmol/L is prevalent in premature ASCVD patients and is significantly associated with a 20% increased risk of subsequent MACE.

Cite This Study

Byrne et al. (2025) conducted a cohort in Premature ASCVD (n=2,684). Elevated lipoprotein(a) (≥150 nmol/L) vs. Lipoprotein(a) <65 nmol/L was evaluated on MACE (composite of MI, ischemic stroke, coronary revascularization, and all-cause death) (HR 1.20, p=<0.05). In patients with premature ASCVD, elevated lipoprotein(a) ≥150 nmol/L was associated with a 20% greater risk of MACE compared to levels <65 nmol/L (HR 1.20, p<0.05).

synapsesocial.com/papers/698828330fc35cd7a88476bb https://doi.org/10.1093/eurheartj/ehaf784.1630

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Implication

Elevated Lp(a) ≥150 nmol/L is prevalent in premature ASCVD patients and is significantly associated with a 20% increased risk of subsequent MACE.

Prevalence of elevated lipoprotein(a) in premature ASCVD patients and its association with major adverse cardiovascular events: analysis of a large US electronic health record database

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Prevalence of elevated lipoprotein(a) in premature ASCVD patients and its association with major adverse cardiovascular events: analysis of a large US electronic health record database

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Also Consider