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June 12, 2026European Journal of Preventive Cardiology0 citationsOpen Access

Experiences with Lp(a) level monitoring in young patients after myocardial infarction

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TRT RatkaiPHP HomrodiGDG Z Duray

Key Result

Among 38 young, low-risk patients with a first myocardial infarction, 21 (55.3%) had elevated Lp(a) levels, averaging 2.2 times the upper limit of normal.

Key Points

  • The aim is to evaluate Lp(a) levels in young patients after myocardial infarction and its implications on cardiovascular risk.
  • Examined patients under 60 years old after myocardial infarction during early rehabilitation.
  • Selected those without diabetes or previous cardiovascular events and who had LDL cholesterol < 3.4 mmol/L.
  • Conducted Lp(a) testing at two time points: post-event and during rehabilitation (2 weeks later).
  • 21 out of 38 patients showed elevated Lp(a) levels, averaging 2.2 times the upper limit of normal.
  • The cohort's elevated Lp(a) was found to be 4.5 times higher than the average population based on literature.
  • Routine Lp(a) screening in low-risk infarction patients could aid in risk stratification and management.

Study Design

Type

Observational (n=38)

Multicenter

Yes

Structured PICO

P
Population
38 young, low-risk patients (mean age 52 years) undergoing early rehabilitation after a first myocardial infarction, without prior diabetes or CV events, and with baseline LDL-C <3.4 mmol/L.
E
Exposure
Lp(a) testing after the acute event and in the second week of the rehabilitation program
O
Outcome
Prevalence and level of elevated Lp(a)surrogate

Routine Lp(a) screening in young, otherwise low-risk patients after myocardial infarction reveals a high prevalence of elevated Lp(a), highlighting its potential utility for risk stratification.

Abstract

Abstract It has been known for years that Lp(a) is a genetically determined, independent risk factor for coronary artery disease and acute myocardial infarction. Due to the lack of treatment options, its routine determination was not performed regularly for years. With the advancement of PCSK-9 inhibitors, it became possible to reduce Lp(a) levels by 20-30%, thereby reducing CV risk. We examined early post-infarction rehabilitation patients in our rehabilitation department. According to our working hypothesis, elevated Lp(a) as an independent CV risk factor occurs cumulatively in low-risk infarction patients. Based on the above, we selected those from the patients after myocardial infarction who came to us for early rehabilitation who: 1.: were younger than 60 years old 2: have not been treated for diabetes before 3: have no former CV event in their anamnesis 4.: and whose LDL - cholesterol level was lower than 3,4 mmol/ l (before the starting of statin therapy). In cooperation with the Military Hospital, during the past year we found a total of 38 such patients, who underwent Lp(a) testing both after the acute event and in the second week of the rehabilitation program. Of the patients, 28 were male and 10 were female. The average age was 52 years (between 38 and 60 years). According to the selection criteria, diabetes and previous treatment for coronary artery disease were not included. 31 patient had a history of hypertension, 27 of them smoked. Laboratory results revealed elevated Lp(a) in 21 patients, with an average elevation of 2.2x the upper limit of normal value, and a maximum of 11x the upper limit of normal. Compared to the average population in the literature, the elevated Lp(a) level in the present study cohort was 4.5x. The above pilot definition draws attention to the fact that in the case of low-risk, young infarcted patients, routine Lp(a) screening and possible treatment can complement the patient's risk stratification, and - with appropriate treatment alternatives - the global risk can be reduced in the patients described above.

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Cite This Study

Ratkai et al. (2026) conducted an observational in Myocardial infarction (n=38). Elevated Lp(a) was evaluated on Elevated Lp(a) prevalence. Among 38 young, low-risk patients with a first myocardial infarction, 21 (55.3%) had elevated Lp(a) levels, averaging 2.2 times the upper limit of normal.

synapsesocial.com/papers/6a2bd1386550ea4541ffe98bhttps://doi.org/10.1093/eurjpc/zwag249.240
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