Lipoprotein(a) and Long-Term Cardiovascular Risk in a Multi-Ethnic Pooled Prospective Cohort
Authors' conclusion
The study shows, in a large U.S. pooled cohort, that higher Lp(a) levels are associated with an increased ASCVD risk, including in patients with diabetes.
Study context
- Population
- Persons aged 20 to 79 years without previous atherosclerotic cardiovascular disease (ASCVD) in 5 US cohorts (MESA, CARDIA, JHS, FHS-OS, ARIC); 55.0% women, 35.6% Black, 7.6% with DM
- Participants
- 27,756 persons5 US cohorts
- Comparison
- Lp percentile categories vs Lp <50th percentile
- Outcome
- Composite incident ASCVD events
- Follow-up
- Mean 21.1 years
Methodological detailsmulti-ethnic, 5 US prospective cohorts, multivariable Cox regression
- Multi-ethnic
- 5 US prospective cohorts
- Multivariable Cox regression
Pooled result
As reported in the abstract
Incident ASCVD events
Each group vs <50th percentileAdjusted hazard ratio (95% CI)
50th to <75th percentile
1.06(0.99–1.14)
75th to <90th percentile
1.18(1.09–1.28)
≥90th percentile
1.46(1.33–1.59)
Further pooled results
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| ASCVD events, by DM status (subgroup)≥90th percentilevs <50th percentileWith DM | 1.92 (1.50–2.45) | interaction P = 0.0056 | |
| ASCVD events, by DM status (subgroup)≥90th percentilevs <50th percentileWithout DM | 1.41 (1.28–1.55) | interaction P = 0.0056 | |
| 0.512Hazard ratio (log scale) |
ASCVD events, by risk group, sex, and race or ethnic group (subgroups)
- Elevated Lp(a) predicted incident ASCVD events similarly by risk group, sex, and race or ethnic groups
MI, revascularization, stroke, CHD death, total mortality
- Lp(a) individually predicted MI, revascularization, stroke and CHD death, but not total mortality
Original publication
Lipoprotein(a) and Long-Term Cardiovascular Risk in a Multi-Ethnic Pooled Prospective Cohort. J Am Coll Cardiol. Published 23 April 2024. doi:10.
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