Incorporation of lipoprotein(a) levels improves calibration of pre-test likelihood estimates of obstructive coronary artery disease
- Lp(a)-adjusted model development with external validation
- derivation cohort
- external validation cohort
+2 more
- derivation cohort
- external validation cohort
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) assessed for obstructive coronary artery diseasederivation cohort 4,262 · external validation cohort 1,595
- Comparison
- RF-CLLp model vs RF-CL model for prediction of obstructive CAD
Performance
As reported in the abstract
Obstructive CAD prevalence (derivation) / significant stenosis (validation)
Further findings
AUC
| Outcome | elevated Lp(a) | RF-CLLp(a) | RF-CL | |
|---|---|---|---|---|
| Area under the receiver operating curve, derivation cohort | Not reported in the abstract | 0.743 (SE 0.011) | 0.740 (SE 0.013) | elevated Lp(a): not reported in the abstract |
Relative risk of obstructive CAD in patients with elevated Lp(a)
- Relative risk, derivation cohort
- 1.51 [95% confidence interval (CI) 1.23-1.86]
- Relative risk, validation cohort
- 1.19 (95% CI 0.88-1.60)
- comparator group not stated
Area under the receiver operating curve, derivation cohort
- RF-CLLp(a) 0.743 (standard error 0.011) vs. RF-CL 0.740 (0.013)
Reclassification from RF-CL to RF-CLLp(a)
- Improved likelihood stratification in the derivation cohort but not in the validation cohort
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:10.1093/ehjci/jeag021
Summarised from the published abstract; every number is checked against it