Key result
Higher Lp(a) levels link to increased arterial stiffness in patients with large apolipoprotein(a) isoforms.
Why the study?
High serum levels of lipoprotein(a) have been associated with increased cardiovascular risk, particularly among individuals with smaller apo(a) isoforms, but their predictive value for early vascular aging in subjects free from CVD is unclear.
Do Lipoprotein(a) serum levels and apo(a) isoform size predict arterial stiffness (cfPWV) in subjects free from cardiovascular disease?
Cross-Sectional (n=978)
No
Do Lipoprotein(a) serum levels and apo(a) isoform size predict arterial stiffness (cfPWV) in subjects free from cardiovascular disease?
Lipoprotein(a) serum levels predict arterial stiffness specifically in primary prevention subjects with large apo(a) isoforms, suggesting a distinct pathophysiological role for isoform size in early vascular aging.
Lp(a) and smaller apo(a) isoforms may predict early vascular aging in CVD-free adults; leaves open incremental value for risk stratification.
In the last decades, high serum levels of lipoprotein(a) (Lp(a)) have been associated with increased cardiovascular disease (CVD) risk, in particular among individuals with smaller apolipoprotein(a) (apo(a)) isoforms than those with larger sizes. The aim of our analysis was to evaluate whether Lp(a) levels could predict early vascular aging, and whether smaller apo(a) isoforms had a predictive value for vascular aging different than larger apo(a) isoforms in a cohort of subjects free from CVD. We considered the data of a subset of Brisighella Heart Study (BHS) participants free from CVD (462 men and 516 women) who were clinically evaluated during the 2012 BHS population survey. Predictors of arterial stiffness, measured as carotid-femoral pulse wave velocity (cfPWV) were estimated by the application of a step-wise linear regression model. In our cohort, there were 511 subjects with small apo(a) size and 467 subjects with large apo(a) isoforms. Subjects with larger apo(a) isoform sizes had significantly lower serum levels of Lp(a). In the BHS subpopulation sample, cfPWV was predicted by age, systolic blood pressure (SBP), serum levels of high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and sex, higher HDL-C serum levels and female sex associated with lower values of cfPWV. In subjects with smaller apo(a) isoform sizes, predictors of cfPWV were age, SBP, sex and serum levels of HDL-C, being higher HDL-C serum levels and female sex associated to lower values of cfPWV. In subjects with larger apo(a) isoform sizes, cfPWV was predicted by age, SBP, serum levels of Lp(a) and sex, with female sex associated with lower values of cfPWV. In our subpopulation sample, Lp(a) did not predict cfPWV. However, in subjects with large apo(a) isoform sizes, Lp(a) was a significant predictor of arterial stiffness.
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Cicero et al. (2022) conducted a cross-sectional in Primary prevention for cardiovascular disease (n=978). Lipoprotein(a) serum levels vs. Smaller apolipoprotein(a) isoform sizes was evaluated on Carotid-femoral pulse wave velocity (cfPWV) (Beta 0.103, 95% CI 0.012-0.218, p=0.004). In subjects with large apolipoprotein(a) isoform sizes, serum levels of Lipoprotein(a) significantly predicted arterial stiffness measured as carotid-femoral pulse wave velocity (Beta 0.103, p=0.004).
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