Lipoprotein(a) and the Early Diagnosis, Complexity, and Extent of Coronary Artery Disease and Myocardial Infarction
Authors' conclusion
Very high Lp(a) is associated with earlier diagnosis of obstructive CAD and MI, predominantly ST-segment elevation MI. In addition, individuals with very high Lp(a) levels seem at a particular high risk of recurrent MI.
Study context
- Population
- Individuals with very high Lp(a) (>230 nmol/L) who underwent routine lipid profiling, and controls with low Lp(a) (≤7 nmol/L)very high Lp(a) 446 · controls with low Lp(a) 223
- Participants
- 446 vs 223
- Comparison
- Individuals with very high Lp compared to those with low Lp
- Very high Lp(a)n = 446
- Low Lp(a)n = 223
- Outcome
- Event-free survival for diagnosis of obstructive CAD and occurrence of MI
- Follow-up
- Median , defined by age at last , was 60 years (Q1-Q3: 50-71)
Methodological detailsmatched 2:1 by age and sex
- Matched 2:1 by age and sex
Main finding
As reported in the abstract
Very high Lp(a): significantly lower event-free survival time for obstructive coronary artery disease (CAD)
P = 0.006
Very high Lp(a): significantly lower event-free survival time for myocardial infarction (MI)
P = 0.012
Further findings
| Outcome | Adjusted OR (per 100 nmol/L) (95% CI) | P value | |
|---|---|---|---|
| Multivessel CADMultivariable analysis | 1.43 (1.04–1.96) | P = 0.028 | |
| Intermediate or high SYNergy Between percutaneous coronary intervention with TAXus and Cardiac Surgery-1 scoreMultivariable analysis | 1.28 (0.82–1.99) | P = 0.279 | |
| 0.512Adjusted odds ratio (log scale) |
ST-segment elevation MI and recurrent MI
- Very high vs low Lp(a): higher risk of ST-segment elevation MI
- 2.4-fold
- Very high vs low Lp(a): higher risk of recurrent MI
- 15.9-fold
Original publication
Lipoprotein(a) and the Early Diagnosis, Complexity, and Extent of Coronary Artery Disease and Myocardial Infarction. JACC Adv. Published 19 January 2026. doi:10.
Summarised from the published abstract; every number is checked against it