Prevention & lipidsMeta-analysis
Efficacy and safety of aspirin for primary prevention in adults with elevated lipoprotein(a) or genetic susceptibility via LPA gene variants: a systematic review and meta-analysis
- Systematic review and meta-analysis
- random-effects (restricted maximum-likelihood (REML) with Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment)
Authors' conclusion
Among adults without ASCVD but with elevated Lp(a) or high-risk LPA genotypes, aspirin use did not confer a statistically significant cardiovascular benefit and was associated with numerically higher bleeding risk.
Study context
- Population
- Adults without ASCVD with elevated Lp(a) (≥50 mg/dL), high-risk LPA genotypes or elevated genetic risk scores
- Participants
- 6,628 adults · 6 studies
- Comparison
- Aspirin vs no aspirin
- Outcome
- Major adverse cardiovascular events (MACE)
Pooled result
As reported in the abstract
Hazard ratio
0.60
95% CI 0.31–1.17
P = 0.1
Aspirin vs No aspirin
HR 0.60 (95% CI 0.31–1.17); P = 0.1
Further pooled results
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| MACE, elevated Lp(a) (subgroup) | 0.63 (0.16–2.49) | P = 0.284 | |
| MACE, LPA rs3798220 carriers (subgroup) · not consistent in the sensitivity analyses | 0.37 (0.19–0.71) | P = 0.003 | |
| 0.10.31310Hazard ratio (log scale) |
Safety
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Clinical bleeding events | 1.24 (0.83–1.87) | P = 0.18 | |
| 0.512Hazard ratio (log scale) |
Original publication
Efficacy and safety of aspirin for primary prevention in adults with elevated lipoprotein(a) or genetic susceptibility via LPA gene variants: a systematic review and meta-analysis. Eur J Prev Cardiol. Published 15 May 2026. doi:10.1093/eurjpc/zwag207
Summarised from the published abstract; every number is checked against it