Lipoprotein(a) and Oxidized Phospholipids Independent Risk Factors for Cardiovascular Disease

USA: A new study published in the Journal of the American College of Cardiology has found that lipoprotein(a) (Lp[a]) and oxidized phospholipids (OxPLs) are independent risk factors for atherosclerotic cardiovascular disease.

The study aimed to evaluate the relationships between Lp(a) particle concentration and OxPLs associated with apolipoprotein B (OxPL-apoB) or apolipoprotein(a) (OxPL-apo[a]) with angiographic CAD and cardiovascular outcomes.

The study, which included 1,098 participants referred for coronary angiography, found that Lp(a) and OxPL-apoB were associated with multivessel CAD, with odds of multivessel CAD per doubling of Lp(a), OxPL-apoB, and OxPL-apo(a) being 1.10, 1.18, and 1.07, respectively.

Additionally, all biomarkers were associated with cardiovascular events, with hazard ratios for major adverse cardiovascular events per doubling of Lp(a), OxPL-apoB, and OxPL-apo(a) being 1.08, 1.15, and 1.07, respectively.

The study revealed the following key takeaways:

1. The median Lp(a) level among participants was 26.45 nmol/L.

2. Lp(a), OxPL-apoB, and OxPL-apo(a) were highly correlated.

3. Lp(a) and OxPL-apoB were associated with multivessel coronary artery disease (CAD).

4. The odds of having multivessel CAD doubled with increasing levels of Lp(a), OxPL-apoB, and OxPL-apo(a).

5. All three biomarkers were associated with cardiovascular events.

“The findings of the study suggest that Lp(a) and OxPL-apoB are important risk factors for atherosclerotic cardiovascular disease and should be considered when assessing risk in patients undergoing coronary angiography. The study also highlights the need for further research into the role of OxPLs in the development and progression of cardiovascular disease.” Said Dr. Thomas Gilliand, the lead author of the study.

Statins are commonly prescribed to reduce the risk of cardiovascular disease, the extent to which Lp(a) and OxPLs predict CAD severity and outcomes in a contemporary, statin-treated cohort is not well established, highlighting the need for further research in this area.

Reference:

Gilliand T., Liu Y., Mohebi R., Miksenas, Haidermota S., Wong M., et al.; Lipoprotein(a), Oxidized Phospholipids, and Coronary Artery Disease Severity and Outcomes; J Am Coll Cardiol. 2023 May, 81 (18) 1780–1792; doi: 10.1016/j.jacc.2023.02.050