The association of lipoprotein(a) and intraplaque neovascularization in patients with carotid stenosis: a retrospective study
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Key result
Plasma lipoprotein(a) concentrations were independently associated with higher intraplaque neovascularization grade in patients with carotid stenosis, with a 1.305-fold higher odds per 100 mg/L increase.
Why the study?
It was unknown whether plasma lipoprotein(a) concentrations are associated with intraplaque neovascularization grade in patients with carotid stenosis.
Does elevated lipoprotein(a) increase intraplaque neovascularization in patients with carotid stenosis?
Population
85 patients with carotid stenosis at Guangdong General Hospital
Comparison
Plasma lipoprotein(a) concentrations and Lp(a) ≥ 300 mg/L vs < 300 mg/L
Design
Retrospective study
Authors
Discussion
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Member takes
Implication
May indicate Lp(a)-driven carotid plaque instability; hypothesis-generating and should not change practice.
Study Design
Type
Observational (n=85)
Multicenter
No
Structured PICO
Does elevated lipoprotein(a) increase intraplaque neovascularization in patients with carotid stenosis?
P
Population
85 patients with carotid stenosis, mean age 68.5 years, evaluated retrospectively to determine the association between plasma lipoprotein(a) concentrations and intraplaque neovascularization.
E
Exposure
Elevated plasma lipoprotein(a) concentrations (evaluated continuously per 100 mg/L increase and categorically as ≥300 mg/L)
C
Comparator
Lower plasma lipoprotein(a) concentrations (or <300 mg/L)
O
Outcome
Intraplaque neovascularization (IPN) grade determined using contrast-enhanced ultrasound (CEUS)surrogate
Main Result
Odds Ratio: 1.305 (95% CI 1.045–1.628)
p-value: p=0.019
Higher plasma lipoprotein(a) concentrations are independently associated with increased intraplaque neovascularization in patients with carotid stenosis, suggesting a potential mechanism for plaque instability.
Limitations
- Observational study design limits causal inferences
- Single-center study with a small sample size of 85 patients
- Did not take genetic variants into consideration
- LDL-C levels were above recommended thresholds in statin-treated patients, which may bias the relationship
- Lack of histological validation for intraplaque neovascularization
- Follow-up data were not collected for cardiovascular and cerebrovascular disease events
- Observational study with limited possibilities to draw causal inferences
- Single-center study with a small sample size (n=85)
- LDL-C levels were above recommended thresholds despite statin therapy, which may bias the relationship
- Lack of histological validation
- No follow-up data collected for cardiovascular and cerebrovascular disease events
Cite This Study
Xia et al. (2021) conducted an observational in Carotid stenosis (n=85). Lipoprotein(a) vs. Lower Lipoprotein(a) levels was evaluated on Intraplaque neovascularization (IPN) grade ≥ 2 (OR 1.305, 95% CI 1.045-1.628, p=0.019). Plasma lipoprotein(a) concentrations were independently associated with higher intraplaque neovascularization grade in patients with carotid stenosis, with a 1.305-fold higher odds per 100 mg/L increase.
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