Aortic & peripheral vascular disease
Lipoprotein(a) and Risks of Peripheral Artery Disease, Abdominal Aortic Aneurysm, and Major Adverse Limb Events
Authors' conclusion
High Lp(a) levels increased risk of PAD, AAA, and MALE by 2- to 3-fold in the general population
Study context
- Population
- General population, Copenhagen General Population Study; Major adverse limb events (MALE) assessed in individuals with peripheral artery disease (PAD) at baseline, replicated in the Copenhagen City Heart Study
- Participants
- 108,146 participants
- Exposure
- Lp ≥99th vs <50th percentile
- Outcome
- Risk of PAD, AAA and major adverse limb events (MALE)
Methodological detailsMendelian randomisation (LPA genotypes), replication cohort, During follow-up, 2,450 developed PAD and 1,251 AAA
- Mendelian randomisation (LPA genotypes)
- Replication cohort
- During follow-up, 2,450 developed PAD and 1,251 AAA
Main finding
As reported in the abstract
PAD, AAA and MALE
Lp(a) ≥99th percentile vs Lp(a) <50th percentileEstimate (95% CI)
PAD; multivariable-adjusted
HR 2.99(2.09–4.30)
AAA; multivariable-adjusted
HR 2.22(1.21–4.07)
MALE, in individuals with PAD
IRR 3.04(1.55–5.98)
- Stepwise increase in risk of PAD and AAA with higher Lp(a)
- P for trend < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Risk ratio (95% CI) | |
|---|---|---|
| Genetically higher Lp(a), per 50 mg/dL (105 nmol/L) — Per 50 mg/dL genetically higher Lp(a) · PAD | 1.39 (1.24–1.56) | |
| Genetically higher Lp(a), per 50 mg/dL (105 nmol/L) — Per 50 mg/dL genetically higher Lp(a) · AAA | 1.21 (1.01–1.44) | |
| Observational risk ratios per 50 mg/dL higher Lp(a) — Per 50 mg/dL higher Lp(a) · PAD | 1.33 (1.24–1.43) | |
| Observational risk ratios per 50 mg/dL higher Lp(a) — Per 50 mg/dL higher Lp(a) · AAA | 1.27 (1.15–1.41) | |
| 0.512Risk ratio (log scale) |
Absolute 10-year risk of PAD, smokers aged 70 to 79 years
Women
Men
Absolute 10-year risk of AAA, smokers aged 70 to 79 years
Women
Men
Original publication
Lipoprotein(a) and Risks of Peripheral Artery Disease, Abdominal Aortic Aneurysm, and Major Adverse Limb Events. J Am Coll Cardiol. Published 12 December 2023. doi:10.
Summarised from the published abstract; every number is checked against it