Prevention & lipidsResearch article
Lipoprotein(a) selectively associates with vulnerable coronary plaque phenotypes in comparison with other established risk markers
- retrospectively analysed
- artificial intelligence-based quantitative coronary computed tomography angiography (CCTA)
- multivariable regression adjusted for age and sex
Authors' conclusion
In asymptomatic primary prevention patients, Lp(a) was independently associated with high-risk coronary plaque features, specifically LDNCP, beyond traditional risk enhancers. These findings highlight the unique role of Lp(a) in identifying coronary plaque vulnerability and suggest complementary roles for Lp(a) and CAC in refining cardiovascular risk stratification.
Study context
- Population
- Asymptomatic primary prevention patients undergoing coronary computed tomography angiography (CCTA) between 2018 and 2024asymptomatic patients undergoing CCTA, median age 56 years, 69.8% male
- Participants
- 547 patients
- Comparison
- Association of Lp(a) with coronary plaque characteristics, compared with LDL-P, high-sensitivity C-reactive protein (hsCRP) and coronary artery calcium (CAC) score
Main finding
As reported in the abstract
Plaque characteristics associated with higher Lp(a)
- Total plaque volume β
- 23.1 mm³, P = 0.006
- Calcified plaque β
- 11.1 mm³, P = 0.014
- Non-calcified plaque β
- 12.0 mm³, P = 0.027
- Low-density non-calcified plaque (LDNCP) β
- 0.4 mm³, P < 0.001
- Area stenosis β
- 1.9%, P = 0.031
- Remodelling index β
- 0.02, P = 0.017
Further findings
Multivariable models: predictors of plaque burden and LDNCP
- CAC score strongest predictor of overall plaque burden, including calcified and non-calcified plaque
- P < 0.000
- Lp(a) independently associated with LDNCP β
- 0.45 mm³, P = 0.013
- CAC score not associated with LDNCP
- LDL-P and hsCRP showed no significant associations
Original publication
Lipoprotein(a) selectively associates with vulnerable coronary plaque phenotypes in comparison with other established risk markers. Eur Heart J Cardiovasc Imaging. Published 28 January 2026. doi:10.1093/ehjci/jeag024
Summarised from the published abstract; every number is checked against it