Lipoprotein(a) and recurrent atherosclerotic cardiovascular events: the US Family Heart 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
Methodological detailsUS medical claims database
- US medical claims database
Main finding
As reported in the abstract
Recurrent ASCVD events
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.
Summarised from the published abstract; every number is checked against it