What is the clinical evidence from this study?

Study design: Cohort. Population: Premature and recurrent atherosclerotic cardiovascular disease (n=7212). Intervention: Elevated lipoprotein(a) ≥ 150 nmol/L vs. Lipoprotein(a) < 65 nmol/L. Primary outcome: Major adverse cardiovascular events (MACE) (HR 1.20, p=0.005).

What does this research mean for the field?

Elevated lipoprotein(a) levels (≥ 150 nmol/L) are associated with a significantly increased risk of major adverse cardiovascular events in patients with premature and recurrent atherosclerotic cardiovascular disease. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine the risk of major adverse cardiovascular events associated with elevated lipoprotein(a) levels in patients with premature or recurrent atherosclerotic cardiovascular disease.

September 5, 2026BMC Cardiovascular DisordersOpen Access

Elevated lipoprotein(a) is associated with increased risk for MACE in patients with premature and recurrent atherosclerotic cardiovascular disease: a large real-world cohort study

Q: What are the key findings of this study?

Elevated Lp(a) ≥ 150 nmol/L was associated with a 20% greater risk of MACE in patients with premature ASCVD (p=0.005) and a 14% greater risk in those with recurrent ASCVD (p=0.013).

Q: What does this research mean for the field?

Elevated lipoprotein(a) levels (≥ 150 nmol/L) are associated with a significantly increased risk of major adverse cardiovascular events in patients with premature and recurrent atherosclerotic cardiovascular disease. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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

To determine the risk of major adverse cardiovascular events associated with elevated lipoprotein(a) levels in patients with premature or recurrent atherosclerotic cardiovascular disease.

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Key result

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

HR 1.20
P=0.005
n=7,212

Why the study?

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

Key Points

To determine the risk of major adverse cardiovascular events associated with elevated lipoprotein(a) levels in patients with premature or recurrent atherosclerotic cardiovascular disease.
Conducted a retrospective cohort study using Optum de-identified Electronic Health Record data from January 1, 2014, to June 30, 2023, analyzing 2,684 premature and 4,528 recurrent ASCVD patients.
Calculated risk and incidence rates of major adverse cardiovascular events (MACE) comparing Lp(a) ≥ 150 nmol/L to Lp(a) < 65 nmol/L using adjusted Cox proportional hazard and Poisson models.
Patients with premature ASCVD and Lp(a) ≥ 150 nmol/L exhibited a 20% greater risk of future MACE (p = 0.005) and 42% more coronary revascularizations (p = 0.005) versus those with Lp(a) < 65 nmol/L.
Patients with recurrent ASCVD and Lp(a) ≥ 150 nmol/L showed a 14% greater risk of future MACE (p = 0.013), a 26% greater risk of myocardial infarction (p < 0.001), and 38% more total heart attacks (p < 0.001) compared with patients having Lp(a) < 65 nmol/L.

Study Design

Type

Cohort (n=7,212)

Structured PICO

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

Population

7,212 patients with premature (n=2,684) or recurrent (n=4,528) ASCVD identified from an electronic health record database.

Exposure

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

Comparator

Lipoprotein(a) [Lp(a)] < 65 nmol/L

Outcome

Major adverse cardiovascular events (MACE)composite

Main Result

Hazard Ratio: 1.2

p-value: p=0.005

Discussion

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Implication

Elevated Lp(a) ≥ 150 nmol/L is significantly associated with an increased risk of MACE, MI, and coronary revascularization in patients with premature or recurrent ASCVD.

Cite This Study

Byrne et al. (2026) conducted a cohort in Premature and recurrent atherosclerotic cardiovascular disease (n=7,212). Elevated lipoprotein(a) ≥ 150 nmol/L vs. Lipoprotein(a) < 65 nmol/L was evaluated on Major adverse cardiovascular events (MACE) (HR 1.20, p=0.005). Elevated Lp(a) ≥ 150 nmol/L was associated with a 20% greater risk of MACE in patients with premature ASCVD (p=0.005) and a 14% greater risk in those with recurrent ASCVD (p=0.013).

synapsesocial.com/papers/6a9bd4346b95aff0620eb9d9 https://doi.org/10.1186/s12872-026-06539-5

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Implication

Elevated Lp(a) ≥ 150 nmol/L is significantly associated with an increased risk of MACE, MI, and coronary revascularization in patients with premature or recurrent ASCVD.

Elevated lipoprotein(a) is associated with increased risk for MACE in patients with premature and recurrent atherosclerotic cardiovascular disease: a large real-world cohort study

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Elevated lipoprotein(a) is associated with increased risk for MACE in patients with premature and recurrent atherosclerotic cardiovascular disease: a large real-world cohort study

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Also Consider