High Lipoprotein(a) Levels Increase Risk of Heart Disease in Diverse Population, finds study

A recent study published in the Journal of the American College of Cardiology highlighted the increased risk of heart disease associated with higher Lipoprotein(a) or Lp(a) levels in a large, multi-ethnic U.S. cohort. The study utilized data from five major U.S. prospective studies that provided significant insights into the genetic risk factors which contributes to atherosclerotic cardiovascular disease (ASCVD).

The research analyzed data from the Multi-Ethnic Study of Atherosclerosis (MESA), the Coronary Artery Risk Development in Young Adults (CARDIA), the Jackson Heart Study (JHS), the Framingham Heart Study-Offspring (FHS-OS) and the Atherosclerosis Risk In Communities (ARIC) study. These studies included a diverse group of 27,756 participants aged between 20 to 79 years without any previous cardiovascular incidents of which 55% were women and 35.6% were identified as Black. The participants were tracked for an average of 21.1 years, during which their Lp(a) levels were closely monitored. Lp(a) levels were categorized based on cohort-specific percentiles, the association between these levels and the incidence of ASCVD events was analyzed using multivariable Cox regression.

The results from this study indicated a clear correlation between higher Lp(a) levels and an increased risk of ASCVD. The participants with Lp(a) levels in the highest percentile (≥90th) experienced a 46% higher risk of cardiovascular events when compared to them with levels below the 50th percentile. This risk appeared consistent across various demographics which included sex and ethnicity. However, the impact of high Lp(a) levels was particularly more pronounced in individuals with diabetes with the risk increased to 92% for the individuals in the highest Lp(a) percentile.

The elevated Lp(a) levels were linked to specific outcomes such as myocardial infarction, revascularization, stroke and coronary heart disease death. Also, the study found no significant association between high Lp(a) levels and overall mortality rates. These findings underline the importance of Lp(a) as a potent genetic risk factor for ASCVD in patients with diabetes which highlights the need for targeted strategies to manage and potentially reduce this risk in the vulnerable populations. The comprehensive analysis of this study reinforces the pivotal role of genetic factors in cardiovascular health and paves the way for future research and treatment approaches that are tailored to individual genetic profiles.

Reference:

Wong, N. D., Fan, W., Hu, X., Ballantyne, C., Hoodgeveen, R. C., Tsai, M. Y., Browne, A., & Budoff, M. J. (2024). Lipoprotein(a) and Long-Term Cardiovascular Risk in a Multi-Ethnic Pooled Prospective Cohort. In Journal of the American College of Cardiology (Vol. 83, Issue 16, pp. 1511–1525). Elsevier BV. https://doi.org/10.1016/j.jacc.2024.02.031