Elevated lipoprotein(a) levels are independently associated with the presence of significant coronary stenosis in de-novo patients with stable chest pain
Authors' conclusion
In stable, symptomatic patients without established coronary artery disease, Lp(a) levels are positively associated with the presence of coronary stenosis on coronary CT angiography. These findings may warrant using Lp(a) in the diagnostic management of patient with suspected coronary artery disease.
Study context
- Population
- Patients with stable chest pain and no previous history of coronary artery disease, included in the Dan-NICAD trial programpatients with Lp(a) measurements and coronary computed tomography (CT) angiography
- Participants
- 4,346 patients
- Exposure
- Normal Lp(a) (< 20 nmol/l) with moderately elevated (20 to <125 nmol/l), high (125 to <200 nmol/l), and very high (≥200 nmol/l) Lp(a) concentrations
- Normal Lp(a)n = 2,418reference
- Moderately elevatedn = 1,276
- Highn = 425
- Very highn = 227
- Outcome
- Prevalence of coronary stenosis
Methodological detailsunivariate and multivariate analyses
- Univariate and multivariate analyses
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Prevalence of multivessel disease
| Outcome | Odds ratio (95% CI) | |
|---|---|---|
| Coronary stenosis (unadjusted model)Moderately elevated vs normal Lp(a) | 1.12 (0.96–1.31) | |
| Coronary stenosis (unadjusted model)High vs normal Lp(a) | 1.42 (1.13–1.77) | |
| Coronary stenosis (unadjusted model)Very high vs normal Lp(a) | 1.67 (1.24–2.22) | |
| 0.512Odds ratio (log scale) |
Coronary stenosis (unadjusted model)
- Adjustment for age, sex, and cardiovascular risk factors did not affect the association
Original publication
Elevated lipoprotein(a) levels are independently associated with the presence of significant coronary stenosis in de-novo patients with stable chest pain. Am Heart J. Published 7 January 2025. doi:10.
Summarised from the published abstract; every number is checked against it