Coronary disease & ACSResearch article
Lipoprotein(a) and the Early Diagnosis, Complexity, and Extent of Coronary Artery Disease and Myocardial Infarction
- nearest-neighbor propensity matching
- matched 2:1 by age and sex
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
Main finding
As reported in the abstract
Event-free survival for diagnosis of obstructive CAD and occurrence of MI · Median follow-up time, defined by age at last follow-up, was 60 years (Q1-Q3: 50-71)
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 CAD · multivariable analysis | 1.43 (1.04–1.96) | P = 0.028 | |
| Intermediate or high SYNergy Between percutaneous coronary intervention with TAXus and Cardiac Surgery-1 score · multivariable 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:10.1016/j.jacadv.2025.102542
Summarised from the published abstract; every number is checked against it