期刊
JOURNAL OF LIPID RESEARCH
卷 63, 期 8, 页码 -出版社
ELSEVIER
DOI: 10.1016/j.jlr.2022.100242
关键词
lipoprotein(a); acute coronary syndrome; CVD; dyslipidemia; atherosclerosis; lipoproteins; vascular biology
资金
- Agence Nationale de la Recherche [ANR-07-PHYSIO-023-01, ANR-10- BLAN-1137]
- National Institutes of Health [R01HL147095, R01HL141917, R01HL136431]
- Boehringer Ingelheim Fonds MD fellowship
- Agence Nationale de la Recherche (ANR) [ANR-10-BLAN-1137] Funding Source: Agence Nationale de la Recherche (ANR)
This study followed a group of elderly individuals for 8 years and found that elevated Lp(a) levels were associated with an increased risk of acute coronary syndrome. The study supports the recommendation of measuring Lp(a) levels in cardiovascular risk assessment.
Elevated circulating lipoprotein (a) [Lp(a)] is associated with an increased risk of first and recurrent cardiovascular events; however, the effect of baseline Lp(a) levels on long-term outcomes in an elderly population is not well understood. The cur-rent single-center prospective study evaluated the association of Lp(a) levels with incident acute coro-nary syndrome to identify populations at risk of future events. Lp(a) concentration was assessed in 755 individuals (mean age of 71.9 years) within the com-munity and followed for up to 8 years (median time to event, 4.5 years; interquartile range, 2.5-6.5 years). Participants with clinically relevant high levels of Lp(a) (>50 mg/dl) had an increased absolute inci-dence rate of ASC of 2.00 (95% CI, 1.0041) over 8 years (P = 0.04). Moreover, Kaplan-Meier cumulative event analyses demonstrated the risk of ASC increased when compared with patients with low (<30 mg/dl) and elevated (30-50 mg/dl) levels of Lp(a) over 8 years (Gray's test; P = 0.16). Within analyses adjusted for age and BMI, the hazard ratio was 2.04 (95% CI, 1.0-4.2; P = 0.05) in the high versus low Lp(a) groups. Overall, this study adds support for recent guidelines recommending a one-time measurement of Lp(a) levels in cardiovascular risk assessment to identify subpopulations at risk and underscores the potential utility of this marker even among older in-dividuals at a time when potent Lp(a)-lowering agents are undergoing evaluation for clinical use.
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