Prevention & lipidsCohort study
Lipoprotein(a) and recurrent atherosclerotic cardiovascular events: the US Family Heart Database
- Retrospective cohort study
- US medical claims database
Authors' conclusion
In 273 770 individuals with ASCVD, higher lipoprotein(a) levels were associated with continuously increasing risk of recurrent ASCVD events regardless of sex and race/ethnicity that may have been partially mitigated by high impact LDL cholesterol-lowering therapy.
Study context
- Population
- Individuals with diagnosed atherosclerotic cardiovascular disease (ASCVD) and lipoprotein(a) measured in nmol/L, US medical claims 2012–202243% women
- Participants
- 273,770 individuals
- Exposure
- Lipoprotein categories vs lipoprotein <15 nmol/L
- Outcome
- Recurrent ASCVD events
- Follow-up
- Median 5.4 years
Main finding
As reported in the abstract
Each group vs <15 nmol/LAdjusted hazard ratio (95% CI)
15-79 nmol/L
1.04(1.01–1.07)
80-179 nmol/L
1.15(1.12–1.19)
180-299 nmol/L
1.29(1.25–1.33)
≥300 nmol/L
1.45(1.39–1.51)
- Individuals with recurrent ASCVD
- 41 687 (15%)
Observational data: associations, not effects.
Further findings
Recurrent ASCVD, by subgroup (interaction with lipoprotein(a) categories)
- Interaction P, sex
- .61
- Interaction P, race/ethnicity
- .06
- Interaction P, baseline ASCVD
- .33
- Interaction P, DM
- .91
- Interaction P, impact of LDL-C-lowering therapy use
- 2 × 10-8
- Results similar for individual ASCVD components and in sex, race/ethnicity, baseline ASCVD and DM subgroups
- High impact LDL-C-lowering therapy possibly mitigates effect of lipoprotein(a) ≥ 180 nmol/L, most pronounced on PCSK9 inhibitors
Original publication
Lipoprotein(a) and recurrent atherosclerotic cardiovascular events: the US Family Heart Database. Eur Heart J. Published 7 May 2025. doi:10.1093/eurheartj/ehaf297
Summarised from the published abstract; every number is checked against it