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September 1, 2026American Journal of Preventive CardiologyOpen Access

Elevated Lp(a) linked to a modestly shorter time to incident CAC>0 from baseline zero.

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Why the study?

Prior studies examined coronary artery calcium testing in individuals with elevated lipoprotein(a), but the optimal timing of initial and repeat testing remained uncertain.

Does elevated Lp(a) >50 mg/dL alter the optimal age for initial CAC testing and the interval for repeat testing in adults?

Population

6,700 MESA study participants with baseline Lp(a)

Comparison

Lp(a) >50 mg/dL vs non-elevated Lp(a)

Design

Observational cohort modeling study

Key result

Elevated Lipoprotein(a) was associated with a modestly shorter time to incident CAC>0 compared to non-elevated Lp(a) (4.2–5.8 vs. 4.5–6.2 years) among participants with baseline CAC=0.

Authors

AKApurva KhedagiARAlexander C. RazaviRBRoger S. Blumenthal

Discussion

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Overview

May inform earlier CAC screening in high Lp(a); leaves open optimal timing and outcomes before practice change.

Study Design

Type

Cohort (n=6,700)

Multicenter

Yes

Structured PICO

Does elevated Lp(a) >50 mg/dL alter the optimal age for initial CAC testing and the interval for repeat testing in adults?

P
Population
6,700 participants with baseline Lp(a) measurements, including 3,362 with baseline CAC=0, evaluated for optimal timing of initial and repeat CAC testing.
E
Exposure
Elevated Lipoprotein(a) (Lp(a) >50 mg/dL)
C
Comparator
Non-elevated Lipoprotein(a)
O
Outcome
Modeled age of initial CAC>0 detection and time to incident CAC>0 (repeat testing interval)surrogate

Elevated Lp(a) modestly shortens the warranty period of a zero CAC score and lowers the modeled age for initial CAC testing, particularly in men with diabetes and women with high risk factor burden.

Cite This Study

Khedagi et al. (2026) conducted a cohort in Elevated Lipoprotein(a) (n=6,700). Elevated Lipoprotein(a) (>50 mg/dL) vs. Non-elevated Lipoprotein(a) was evaluated on Time to incident CAC>0 among participants with baseline CAC=0. Elevated Lipoprotein(a) was associated with a modestly shorter time to incident CAC>0 compared to non-elevated Lp(a) (4.2–5.8 vs. 4.5–6.2 years) among participants with baseline CAC=0.

synapsesocial.com/papers/6a9f674eaccb0daecaf7deebhttps://doi.org/10.1016/j.ajpc.2026.101815
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Lipoprotein(a) screening in young and middle-aged patients presenting with acute coronary syndrome2018 · 29 citations
  2. 2Coronary calcification is associated with elevated serum lipoprotein (a) levels in asymptomatic men over the age of 45 years2021 · 21 citations
  3. 3Coronary Artery Calcium in Relation to Initiation and Continuation of Cardiovascular Preventive Medications2010 · 81 citations
  4. 4Association of Lipoprotein(a) with Progression of Coronary Artery Calcification: Retrospective Longitudinal Study2024 · 2 citations
  5. 5Age-related Contribution of Lp (a) with Coronary Artery Calcification in Patients with Acute Coronary Syndrome: a Potential Role of Metabolic Disorder in Calcified Plaque2003 · 12 citations