Prevention & lipidsCohort study
The additive prognostic value of lipoprotein(a) for all-cause and cardiovascular mortality across the traditional cardiovascular risk continuum: analysis from NHANES III (1988–1994) with follow-up to 2019
- Retrospective cohort study
- nationally representative
- survey-weighted
- multivariable Cox and Fine-Gray competing risk models
Authors' conclusion
Elevated Lp(a) levels (> 75 mg/dL) are associated with increased all-cause and CV mortality among individuals with high baseline traditional CV risk, as defined by the AHA's PREVENT score, independent of traditional risk factors.
Study context
- Population
- US adults, NHANES III (1988–1994), mortality follow-up through 2019survey-weighted
- Participants
- 55,050,155 adults
- Exposure
- Lp levels, stratified by baseline cardiovascular (CV) risk
- Outcome
- All-cause and CV mortality
- Follow-up
- Mean 22.4 years (±7.07)
Main finding
As reported in the abstract
All-cause and CV mortality, high baseline CV risk
Estimate (95% CI)
Lp(a) >75 mg/dLall-cause mortality, high-risk
HR 1.25(1.02–1.53)
Lp(a) >75 mg/dLCV mortality, high-risk
sHR 1.21(1.09–1.36)
Lp(a) 50-75 mg/dLall-cause mortality, high-risk; borderline
HR 1.16(1.00–1.34)
Lp(a) 50-75 mg/dLCV mortality, high-risk
sHR 1.06(0.98–1.15)
Observational data: associations, not effects.
Further findings
Prevalence of elevated Lp(a) (>50 mg/dL)
- Overall
- 15%
- High-risk
- 15%
- Low-risk
- 11%
Original publication
The additive prognostic value of lipoprotein(a) for all-cause and cardiovascular mortality across the traditional cardiovascular risk continuum: analysis from NHANES III (1988–1994) with follow-up to 2019. Eur J Prev Cardiol. Published 14 January 2026. doi:10.1093/eurjpc/zwag037
Summarised from the published abstract; every number is checked against it