Lipoprotein (a) and the Occurrence of Lipid Disorders and Other Cardiovascular Risk Factors in Patients Without Diagnosed Cardiovascular Disease

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Aug 29

PMID 39200791

Authors

Jakub Ratajczak

Aldona Kubica

Lukasz Pietrzykowski

Piotr Michalski

Agata Kosobucka-Ozdoba

Krzysztof Buczkowski

Magdalena Krintus

Piotr Jankowski

Jacek Kubica

Affiliations

Soon will be listed here.

Abstract

: Elevated lipoprotein (a) [Lp(a)] concentrations are linked mainly to genetic factors. The relationship between Lp(a) and other lipid disorders or cardiovascular (CV) risk factors has been less investigated. The aim of this study was to assess the occurrence of lipid disorders and other CV risk factors according to Lp(a) concentrations. : A cross-sectional analysis of 200 primary-care patients who had not been diagnosed with CV disease was conducted. The following risk factors were assessed: older age, history of hypertension, diabetes mellitus or dyslipidemia, smoking, lack of physical activity, body mass index (BMI), and waist circumference. The following lipid parameters were measured: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and small, dense LDL (sdLDL-C). Patients were divided into two groups based on their Lp(a) concentrations: <30 mg/dL and ≥30 mg/dL. : In 70% of patients, the Lp(a) concentration was <30 mg/dL. The concentrations of lipid parameters did not differ between the groups. The rate of patients with sdLDL-C >1.0 mmol/L was higher in the low-Lp(a) group (10.0 vs. 1.7%, = 0.04), with no significant differences regarding the other analyzed lipid disorders ( > 0.05). Both in the low- and high-Lp(a) group, most patients had two other abnormal lipid factors (45.0% and 60.0%, respectively). The distribution of impaired lipid parameters ( = 0.41) and other CV risk factors ( = 0.16) was similar in both groups. There was a lower rate of patients >60 years old (15.0% vs. 32.9%, = 0.01) and with a BMI ≥ 25 kg/m (46.7% vs. 63.6%, = 0.026) in the high-Lp(a) group, and previously diagnosed hyperlipidemia was more prevalent in this group (65.0% vs. 47.1%, = 0.02). The occurrence of other cardiovascular risk factors did not differ significantly between the Lp(a) groups ( > 0.05). In the high-Lp(a) group, the highest proportion (25.0%) had two CV risk factors, and in the low-Lp(a) group, 31.4% had four CV risk factors. : An elevated Lp(a) concentration is not related to the number of conventional CV risk factors or other impairment major lipid parameters.

References

Cai D, He Y, Yang X, Zhao X, Xu H . Lipoprotein (a) is a risk factor for coronary artery disease in Chinese Han ethnic population modified by some traditional risk factors: A cross-sectional study of 3462 cases and 6125 controls. Clin Chim Acta. 2015; 451(Pt B):278-86. DOI: 10.1016/j.cca.2015.10.009. View

Oo H, Giovannucci J, OBrien R, Hare D . The Prevalence of Elevated Lipoprotein(a) in Patients Presenting With Coronary Artery Disease. Heart Lung Circ. 2020; 29(11):1682-1687. DOI: 10.1016/j.hlc.2020.03.005. View

Mitkowski P, Witkowski A, Stepinska J, Banach M, Jankowski P, Gasior M . Position of the Polish Cardiac Society on therapeutic targets for LDL cholesterol concentrations in secondary prevention of myocardial infarctions. Kardiol Pol. 2023; 81(7-8):818-823. DOI: 10.33963/KP.a2023.0162. View

Carr S, Hooper A, Sullivan D, Burnett J . Non-HDL-cholesterol and apolipoprotein B compared with LDL-cholesterol in atherosclerotic cardiovascular disease risk assessment. Pathology. 2019; 51(2):148-154. DOI: 10.1016/j.pathol.2018.11.006. View

Konieczynska M, Nowak K, Pudlo J, Zasada M, Tlalka M, Wypasek E . Elevated lipoprotein(a) in the middle-aged Polish population: Preliminary data on the genetic background. Kardiol Pol. 2023; 81(12):1279-1281. DOI: 10.33963/v.kp.97660. View

Enkhmaa B, Berglund L . Non-genetic influences on lipoprotein(a) concentrations. Atherosclerosis. 2022; 349:53-62. PMC: 9549811. DOI: 10.1016/j.atherosclerosis.2022.04.006. View

Boerwinkle E, Leffert C, Lin J, Lackner C, Chiesa G, Hobbs H . Apolipoprotein(a) gene accounts for greater than 90% of the variation in plasma lipoprotein(a) concentrations. J Clin Invest. 1992; 90(1):52-60. PMC: 443062. DOI: 10.1172/JCI115855. View

Kubica A, Pietrzykowski L, Michalski P, Kasprzak M, Ratajczak J, Siodmiak J . The occurrence of cardiovascular risk factors and functioning in chronic illness in the Polish population of EUROASPIRE V. Cardiol J. 2022; 31(4):612-620. PMC: 11374325. DOI: 10.5603/CJ.a2022.0102. View

Statescu C, Anghel L, Benchea L, Tudurachi B, Leonte A, Zavoi A . A Systematic Review on the Risk Modulators of Myocardial Infarction in the "Young"-Implications of Lipoprotein (a). Int J Mol Sci. 2023; 24(6). PMC: 10051886. DOI: 10.3390/ijms24065927. View

10.

Lamina C, Ward N . Lipoprotein (a) and diabetes mellitus. Atherosclerosis. 2022; 349:63-71. DOI: 10.1016/j.atherosclerosis.2022.04.016. View

11.

Reyes-Soffer G, Ginsberg H, Berglund L, Duell P, Heffron S, Kamstrup P . Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association. Arterioscler Thromb Vasc Biol. 2021; 42(1):e48-e60. PMC: 9989949. DOI: 10.1161/ATV.0000000000000147. View

12.

Nowowiejska-Wiewiora A, Wita K, Medrala Z, Tomkiewicz-Pajak L, Bujak K, Mizia-Stec K . Dyslipidemia treatment and attainment of LDL-cholesterol treatment goals in patients participating in the Managed Care for Acute Myocardial Infarction Survivors program. Kardiol Pol. 2023; 81(4):359-365. DOI: 10.33963/KP.a2023.0045. View

13.

Visseren F, Mach F, Smulders Y, Carballo D, Koskinas K, Back M . 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021; 42(34):3227-3337. DOI: 10.1093/eurheartj/ehab484. View

14.

Varvel S, McConnell J, Tsimikas S . Prevalence of Elevated Lp(a) Mass Levels and Patient Thresholds in 532 359 Patients in the United States. Arterioscler Thromb Vasc Biol. 2016; 36(11):2239-2245. DOI: 10.1161/ATVBAHA.116.308011. View

15.

Burgess S, Ference B, Staley J, Freitag D, Mason A, Nielsen S . Association of LPA Variants With Risk of Coronary Disease and the Implications for Lipoprotein(a)-Lowering Therapies: A Mendelian Randomization Analysis. JAMA Cardiol. 2018; 3(7):619-627. PMC: 6481553. DOI: 10.1001/jamacardio.2018.1470. View

16.

Raitakari O, Kivela A, Pahkala K, Rovio S, Mykkanen J, Ahola-Olli A . Long-term tracking and population characteristics of lipoprotein (a) in the Cardiovascular Risk in Young Finns Study. Atherosclerosis. 2022; 356:18-27. DOI: 10.1016/j.atherosclerosis.2022.07.009. View

17.

Kronenberg F, Mora S, Stroes E, Ference B, Arsenault B, Berglund L . Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur Heart J. 2022; 43(39):3925-3946. PMC: 9639807. DOI: 10.1093/eurheartj/ehac361. View

18.

Kotseva K, De Backer G, De Bacquer D, Ryden L, Hoes A, Grobbee D . Primary prevention efforts are poorly developed in people at high cardiovascular risk: A report from the European Society of Cardiology EURObservational Research Programme EUROASPIRE V survey in 16 European countries. Eur J Prev Cardiol. 2021; 28(4):370-379. DOI: 10.1177/2047487320908698. View

19.

Kaltoft M, Langsted A, Afzal S, Kamstrup P, Nordestgaard B . Lipoprotein(a) and Body Mass Compound the Risk of Calcific Aortic Valve Disease. J Am Coll Cardiol. 2022; 79(6):545-558. DOI: 10.1016/j.jacc.2021.11.043. View

20.

. Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials. Lancet. 2019; 393(10170):407-415. PMC: 6429627. DOI: 10.1016/S0140-6736(18)31942-1. View