Aortic & peripheral vascular diseaseCohort study
Lipoprotein(a) and Risks of Peripheral Artery Disease, Abdominal Aortic Aneurysm, and Major Adverse Limb Events
- Prospective cohort study
- Mendelian randomisation (LPA genotypes)
- replication cohort
- During follow-up, 2,450 developed peripheral artery disease (PAD) and 1,251 AAA
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 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)
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:10.1016/j.jacc.2023.10.009
Summarised from the published abstract; every number is checked against it