Relation of Lp (a) with plaque characteristics and clinical events: ATHEROREMO and IBIS₃ cohorts

Abstract Background 75% were male; 32% had Lp(a) 75 nmol/L. Patients with Lp(a) 75 nmol/L had a significantly higher prevalence of hypercholesterolemia and prior percutaneous coronary intervention. These patients demonstrated higher IVUS-derived plaque burden (40.1% vs. 38.3%, p=0.024), though no associations were found with other plaque characteristics, e.g. minimum lumen area, thin-cap fibroatheroroma, and NIRS-derived lipid core burden index. No association was found between Lp(a) and long-term major adverse cardiac events (hazard ratio HR 1.12, 95% confidence interval CI 0.80–1.57, p = 0.51) and all-cause mortality (HR 0.69, 95% CI 0.46–1.02, p = 0.070). Conclusions Among patients with established ASCVD, Lp(a) was associated with plaque burden, supporting evidence that relates Lp(a) to atherosclerotic processes. However, Lp(a) was not associated with long-term cardiac adverse events or mortality in these patients.