Incorporation of lipoprotein(a) levels improves calibration of pre-test likelihood estimates of obstructive coronary artery disease
Authors' conclusion
Adding elevated Lp(a) as a risk factor to the RF-CL model improves accuracy of obstructive CAD in patients with high Lp(a).
Study context
- Population
- Patients without known coronary artery disease (CAD)derivation and external validation cohorts · Derivation cohort 4,262 · External validation cohort 1,595
- Index test or model
- RF-CLLp(a) vs RF-CL against obstructive CAD at invasive angiography with fractional flow reserve (validation: significant stenosis at invasive angiography or coronary computed tomography)
- Target condition
- obstructive coronary artery disease (CAD)
Methodological detailsderivation cohort, external validation cohort
- Derivation cohort
- External validation cohort
Performance
As reported in the abstract
RF-CLLp(a)
0.743
AUROC · SE 0.011
RF-CL
0.740
AUROC · SE 0.013
Further findings
Obstructive CAD in patients with elevated Lp(a)
| Relative risk (95% CI) | ||
|---|---|---|
| Elevated Lp(a)Derivation cohort | 1.51 (1.23–1.86) | |
| Elevated Lp(a)Validation cohort | 1.19 (0.88–1.60) | |
| 0.512Relative risk (log scale) |
Calibration (derivation cohort)
- RF-CLLp(a) showed better calibration in patients with elevated Lp(a)
Reclassification from RF-CL to RF-CLLp(a)
- Improved likelihood stratification in the derivation cohort but not in the validation cohort
Prevalence of obstructive CAD / significant stenosis
Patients
- Derivation cohort, obstructive CAD
- 473 (11.1%)
- Validation cohort, significant stenosis
- 206 (12.9%)
Original publication
Incorporation of lipoprotein(a) levels improves calibration of pre-test likelihood estimates of obstructive coronary artery disease. Eur Heart J Cardiovasc Imaging. Published 5 February 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →