AHA PREVENT Equations and Lipoprotein(a) for Cardiovascular Disease Risk : Insights From Multi-Ethnic Study of Atherosclerosis (MESA) and the UK Biobank
Main finding · ASCVDResult — go to the resultHazard ratio 1.30 95% CI 1.22–1.38Authors' conclusion
In this analysis of 2 cohort studies, the novel PREVENT equations performed well for risk prediction overall, including among individuals with elevated Lp(a). However, Lp(a) values remain independently associated with higher risk
Study context
- Population
- Individuals without known CVD with available Lp(a) measurements (MESA 2000–2018; UK Biobank (UKB) 2006–2022)MESA n = 6670
- Participants
- 314,783 individuals
- Exposure
- Elevated vs nonelevated Lp in PREVENT risk prediction
- Outcome
- CHD, ASCVD, HF and total CVD; performance of PREVENT equations and NRI with addition of elevated Lp(a)
- Follow-up
- 10 years
Methodological details2 cohorts (MESA, UK Biobank)
- 2 cohorts (MESA, UK Biobank)
Main finding
ASCVD
Hazard ratio
1.30
95% CI 1.22–1.38
Elevated Lp(a)vs Nonelevated Lp(a)
HR 1.30 (95% CI 1.22–1.38)
As reported in the abstract
- Category-free net reclassification improvement (NRI) with addition of elevated Lp(a) to PREVENT (ASCVD)
- 0.058 (95% CI, 0.043-0.065)
- Categorical NRI (ASCVD)
- 0.006 (95% CI, 0.004-0.011)
Observational data: associations, not effects.
Further findings
Coronary heart disease (CHD), by risk category (subgroup)
- Strongest association among low-risk individuals
- P for interaction = 0.31
- Greatest improvement in prediction in low- and high-risk individuals
ASCVD NRI by risk category (subgroup)
- Greatest improvement in borderline-risk; with continuous Lp(a), greatest improvement among low risk
Original publication
AHA PREVENT Equations and Lipoprotein(a) for Cardiovascular Disease Risk : Insights From MESA and the UK Biobank. JAMA Cardiol. Published 1 August 2025. doi:10.
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