Sex-Specific Differences Observed in Lipoprotein(a) Levels to Predict Coronary Artery Disease in new study

A recent study from the Koc University Hospital revealed crucial insights into the relationship between lipoprotein(a) [Lp(a)] levels and the risk of coronary artery disease (CAD), with notable differences based on sex. The study published in the journal of Clinical Cardiology was set out to clarify the inconsistent findings from earlier research by examining how Lp(a) levels influence CAD risk in men and women separately.

Lp(a) is a well-established risk factor for coronary artery disease. However, there has been ongoing debate about whether the association between elevated Lp(a) levels and CAD differs between men and women. This study wanted to settle the question by analyzing Lp(a) levels in a large cohort of patients and exploring whether sex-specific differences exist in the Lp(a)-CAD relationship.

The study analyzed data from a total of 1,858 patients admitted to the tertiary care facility at Koc University Hospital. With an average age of 54 years, 53.33% of the patients were female which provided a robust sample for exploring sex-based differences. Two widely accepted Lp(a) thresholds (≥30 mg/dL and ≥50 mg/dL) were used to categorize patients and evaluate their risk of developing CAD.

The results of this study indicated that elevated Lp(a) levels were an independent predictor of CAD across the entire patient cohort. Both thresholds (≥30 mg/dL and ≥50 mg/dL) were found to be significantly associated with CAD risk, with a p-value of less than 0.001. However, when broken down by sex, the study found an Lp(a) level of ≥30 mg/dL was a strong, independent predictor of CAD (p < 0.001) among women. This was not the case for men, where the same threshold did not show a significant association. At the higher threshold of ≥50 mg/dL, Lp(a) levels were predictive of CAD in both men and women, but the significance was more pronounced in men (p = 0.004) than in women (p = 0.047).

These findings suggest that Lp(a) levels may need to be interpreted differently for men and women when assessing CAD risk. For women, a lower Lp(a) threshold (≥30 mg/dL) may be sufficient to warrant closer monitoring or preventive measures. In contrast, for men, the study suggests that the higher threshold (≥50 mg/dL) should be used for CAD risk stratification. Overall, this study highlights the importance of personalized approaches in cardiovascular risk assessment. It also illuminates the need for further research to refine Lp(a)-based risk thresholds and optimize preventive strategies for both men and women.

Reference:

Yurtseven, E., Ural, D., Gursoy, E., Cunedioglu, B. O., Guler, O. U., Baysal, K., Aytekin, S., Aytekin, V., & Kayakcioglu, M. (2024). Is There a Need for Sex‐Tailored Lipoprotein(a) Cut‐Off Values for Coronary Artery Disease Risk Stratification? In Clinical Cardiology (Vol. 47, Issue 9). Wiley. https://doi.org/10.1002/clc.70012