Key result
Elevated Lp(a) is linked to ~57% higher odds of cardiovascular events.
Why the study?
The ELITE study prospectively collected data on cardiovascular risk factors, cognitive function, and quality of life to identify reasons for lack of implementation of targeted individual information and improve participant health.
Does elevated Lipoprotein(a) increase the risk of incident cardiovascular events in community-dwelling individuals?
Cohort (n=4,078)
No
Does elevated Lipoprotein(a) increase the risk of incident cardiovascular events in community-dwelling individuals?
Odds Ratio: 1.574
Absolute Event Rate: 15.1% vs 11.4%
p-value: p=<0.001
Elevated Lipoprotein(a) is independently associated with a higher risk of cardiovascular events, underscoring the need for targeted screening and intensive management of other modifiable risk factors.
Supports Lp(a) measurement for risk stratification; extends observational cohorts but leaves open need for trials before practice change.
BACKGROUND: In ELITE (Ernährung, Lebensstil und individuelle Information zur Verhinderung von Herzinfarkt, Schlaganfall und Demenz; german for: Nutrition, Lifestyle and Individual Information for the Prevention of Heart Attack, Stroke and Dementia) data on cardiovascular risk factors, cognitive function and quality of life are prospectively collected, which will be improved through targeted individual information. The aim is to improve the health of the participants and identify the reasons for the lack of implementation. METHODS: Risk factors of 4602 participants were linked to (controlled) hypertension and mild cognitive impairment (MCI). Blood pressure was measured according to the guidelines and the DEMTECT- test was used to detect MCI. RESULTS: The most common risk factor was hypertension (60%). Hypertensive patients were older (56.1 and 44.7 years), had a higher BMI (28 and 24.8 kg/m), frequently physical inactive (26 and 32.4%), diabetes (9.3 and 1.3%), higher LDL (134.7 and 124.1 mg/dl), higher triglycerides (169.6 and 124.8 mg/dl) and lower HDL (57.9 and 65.5 mg/dl) compared with normotensives (P < 0.001). Controlled hypertensive patients are less common men (46.1 and 52.1%, P < 0.001), have a lower BMI (28.3 and 29.1 kg/m, P < 0.001), lower LDL (129.0 and 135.6 mg/dl, P = 0.004) and lower triglycerides (162.5 and 182.3 mg/dl, P = 0.001) compared with treated uncontrolled hypertensive patients. Antihypertensives per person (2.015; 2.017) do not differ. The prevalence of MCI is highly significantly associated with the number of risk factors. in participants without risk factors, the prevalence is 3.9%, in participants with 4 risk factors, 16.3%. In hypertensive patients, the frequency is 11.8% compared with 4.8% for normotensives (P < 0.001). The occurrence of MCI depends significantly from age, blood pressure and diabetes CONCLUSION:: The frequency of MCI is highly significantly associated with the number of cardiovascular risk factors, regardless of age. The prevalence was particularly high among hypertensive patients, which is not often described. The occurrence of MCI depends significantly from age, blood pressure and diabetes. The metabolic syndrome and lack of exercise complicate blood pressure control.
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Schrader et al. (2020) conducted a cohort in Cardiovascular risk (n=4,078). Elevated Lipoprotein(a) (≥75 nmol/L) vs. Normal Lipoprotein(a) (<75 nmol/L) was evaluated on Combined cardiovascular endpoint (coronary heart disease with or without myocardial infarction, stroke, carotid stenosis, atrial fibrillation or peripheral artery disease) (OR 1.574, p=<0.001). Elevated Lipoprotein(a) levels (≥75 nmol/L) were associated with a significantly increased risk of cardiovascular events compared to normal levels (15.1% vs 11.4%, adjusted OR 1.574, p<0.001) over a 4.4-year follow-up.
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