Key result
Elevated Lp(a) is linked to ~1% higher odds of ischemic heart disease per mg/dl.
Why the study?
The distribution of Lp(a) concentrations by age and sex and its association with ischemic heart disease in the Russian adult population needed evaluation.
Does elevated Lipoprotein(a) concentration correlate with increased prevalence of ischemic heart disease in the adult Russian population?
Cross-Sectional (n=73,763)
Yes
Does elevated Lipoprotein(a) concentration correlate with increased prevalence of ischemic heart disease in the adult Russian population?
Odds Ratio: 1.006 (95% CI 1.003–1.008)
p-value: p=<0.001
In a large Russian cohort, elevated Lipoprotein(a) >30 mg/dl is highly prevalent (26%) and linearly associated with a significantly increased odds of ischemic heart disease, emphasizing the need for widespread screening.
Should not yet change practice; leaves open causal role and need for prospective Lp(a) trials in this population.
Aim To study the distribution of lipoprotein(a) [Lp(a)] concentrations in a large sample of the adult population of the Russian Federation depending on gender and age, and the Lp(a) association with the incidence of ischemic heart disease (IHD).Material and methods Cross-analysis of electronic medical records of patients older than 18 years managed in the MEDSI Group of Companies as a part of primary and secondary prevention.Results Among 73,763 patients, the mean age was 45 [37; 56] years, 57.3% were women. The median Lp(a) concentration was 11 [6.0; 32.0] mg/dl. The median Lp(a) concentration in women was higher than in men, 12.0 and 10.5 mg/dl, respectively (p<0.0001). Hyperlipoproteinemia(a) (Lp(a) >30 mg/dl) was diagnosed in 26% (n=19,188) of patients (95% confidence interval (CI): 25.7-26.3), statistically significant association with IHD was observed over the entire range of elevated Lp(a) concentrations (p<0.001). Extremely high Lp(a) concentrations exceeding 180 mg/dl were detected in 852 (1.2%) of patients, and 210 of them were diagnosed with IHD. Logistic regression analysis confirmed a significant association between Lp(a) concentrations and IHD (odds ratio (OR) 1.006; 95% CI 1.003-1.008; p<0.001). With an increase in Lp(a) by 1 mg/dl, the likelihood of having IHD increased by 1.006 times. With Lp(a) >50 mg/dL, the likelihood of IHD increased by 1.32 times (OR 1.320; 95% CI 1.254-1.390; p<0.001), with Lp(a) >180 mg/dL, by 2.06 times (OR 2.058; 95% CI 1.758-2.408), and with Lp(a) 30-50 mg/dL, by 1.1 times (OR 1.100; 95% CI 1.017-1.188; p=0.016).Conclusion Every fourth person has an elevated Lp(a) concentration, which determines a high risk of developing cardiovascular diseases. Taking into account the accumulated data, early assessment of the Lp(a) concentration is necessary for all adults.
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Konovalov et al. (2025) conducted a cross-sectional in General adult population evaluated for primary and secondary prevention (n=73,763). Elevated Lipoprotein(a) concentration vs. Lower Lipoprotein(a) concentration was evaluated on Ischemic heart disease (IHD) (OR 1.006 per 1 mg/dl increase, 95% CI 1.003-1.008, p=<0.001). Elevated Lipoprotein(a) concentrations are significantly and linearly associated with a higher likelihood of having ischemic heart disease, increasing by 1.006 times for each 1 mg/dl increase.
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