Association of Lipoprotein(a) With Coronary Atherosclerosis and Cardiovascular Events: Findings From the SCAPIS Cohort
Authors' conclusion
The findings suggest that Lp(a) increases coronary event risk primarily by driving a higher burden of atherosclerosis and that high Lp(a) accounts for 5% to 10% of total coronary disease burden in the population.
Study context
- Population
- Middle-aged individuals from the general population (SCAPIS, Sweden)25,916 with coronary CT angiography
- Participants
- 28,529 individuals
- Exposure
- High Lp vs not high Lp
- Outcome
- Coronary atherosclerosis (coronary CT angiography) and incident coronary events (fatal or nonfatal MI)
- Follow-up
- Median 7.8 years
Methodological detailsmediation analysis
- Mediation analysis
Main finding
As reported in the abstract
High Lp(a)
14%
High Lp(a)Estimate (95% CI)
Severe/extensive coronary atherosclerosis (Segment Involvement Score >4)
OR 1.38(1.21–1.57)
Coronary events
HR 1.54(1.18–2.0)
Observational data: associations, not effects.
Further findings
Mediation of Lp(a)–coronary event association by atherosclerotic burden
- Association largely explained by greater atherosclerotic burden (P for mediation)
- <0.0001
Earlier development of atherosclerosis with high Lp(a)
- Atherosclerosis developed earlier, years
- 2 to 3
Population-attributable fraction of Lp(a)
- Severe atherosclerosis
- 5% to 10%
- Coronary events
- around 7%
Original publication
Association of Lipoprotein(a) With Coronary Atherosclerosis and Cardiovascular Events: Findings From the SCAPIS Cohort. JACC Cardiovasc Imaging. Published 18 July 2026. doi:10.
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