ArticleBMC cardiovascular disorders2022
The correlation between lipoprotein(a) elevations and the risk of recurrent cardiovascular events in CAD patients with different LDL-C levels.
Article in BMC cardiovascular disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Prognostic value of elevated lipoprotein (a) in patients with acute coronary syndromes: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2024Pooled it
- Article
- Therapeutic inertia and lipid-lowering treatment modification after acute coronary syndrome: a longitudinal real-world study using a lagged decision-outcome design.Lipids in health and disease · 2026Article
- Lipoprotein(a): structural basis, bidirectional risk, and therapeutic frontiers.Journal of clinical biochemistry and nutrition · 2026Article
- Analysis of the Predictive Effect of Cardiac Color Doppler Ultrasound Combined With Carotid Ultrasound on Major Adverse Cardiac Events Following Percutaneous Coronary Intervention.Echocardiography (Mount Kisco, N.Y.) · 2025Article
- Lipoprotein(a) levels in Irish subjects from a specialised lipid centre.Irish journal of medical science · 2025Article
- The interactions of Lipoprotein(a) with common cardiovascular risk factors in cardiovascular disease risk: evidence based on the UK Biobank.American journal of preventive cardiology · 2025Article
- Interaction Between Lipoprotein(a) and Other Lipid Molecules: A Review of the Current Literature.Biomolecules · 2025Review
- Lipoprotein (a): Underrecognized Risk with a Promising Future.Reviews in cardiovascular medicine · 2024Review
- LDL-C and hs-CRP Jointly Modify the Effect of Lp(a) on 5-Year Death in Patients With Percutaneous Coronary Intervention.Clinical cardiology · 2024Observational
- Frequency of lipoprotein(a) testing and its levels in Pakistani population.Global cardiology science & practice · 2024Article
- Association between lipoprotein(a) and premature atherosclerotic cardiovascular disease: a systematic review and meta-analysis.European heart journal open · 2024Article
- Lipoprotein(a) and Atherosclerotic Cardiovascular Disease: Where Do We Stand?International journal of molecular sciences · 2024Review
- Lipoprotein(a) is associated with DNA damage in patients with heterozygous familial hypercholesterolemia.Scientific reports · 2024Article
- Relationship between carotid atherosclerosis and lipoprotein (a) in patients with acute ischemic stroke.Frontiers in neurology · 2024Article
- Lipoprotein(a) and thromboembolism: current state of knowledge and unsolved issues.Archives of medical science : AMS · 2024Article
- Confounding Factors Responsible for Elevated Lp(a) Levels in Patients with Coronary Artery Disease.Annals of cardiac anaesthesia · 2024Article
- Secondary Prevention and Extreme Cardiovascular Risk Evaluation (SEVERE-1), Focus on Prevalence and Associated Risk Factors: The Study Protocol.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2023Article
- Machine learning-based analysis of risk factors for chronic total occlusion in an Asian population.The Journal of international medical research · 2023Article
- The Comparison of the Associations of Lipoprotein(a) and the Atherogenic Index of Plasma With Coronary Artery Calcification in Patients Without High LDL-C: A Comparative Analysis.Journal of lipid and atherosclerosis · 2023Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLipoprotein(a) [Lp(a)] elevation is an important risk factor for coronary artery disease (CAD). However, the correlation between Lp(a) elevations and the risk of recurrent cardiovascular events in patients with established cardiovascular disease is controversial. Some studies have shown that Low-density lipoprotein cholesterol (LDL-C) levels may influence the association between Lp(a) and cardiovascular risk. Our study aims to explore the correlation between Lp(a) elevations and cardiovascular risk in patients with different LDL-C levels.
methodsWe included 516 patients who received coronary stents due to acute coronary syndrome (ACS) and followed them for three years. They were divided into low-Lp(a) group and high-Lp(a) group according to Lp(a) levels, and the incidence of major adverse cardiovascular events (MACE) and acute coronary events (ACE) was compared between the two groups. Then the patients were divided into three subgroups (S1:LDL-C ≥ 1.8 mmol/L; S2:1.4 ≤ LDL-C < 1.8 mmol/L; S3:LDL-C < 1.4 mmol/L). The correlation between Lp(a) elevations and cardiovascular risk in different subgroups was analysed by Cox proportional hazards models.
resultsThe incidence of MACE and ACE in the high-Lp(a) group was significantly higher than those in the low-Lp(a) group (P < 0.05). Lp(a) elevations had independent prognostic value from the statistical point of view (MACE: HR = 1.63, 95%CI = 1.12-2.38, P = 0.012; ACE: HR = 1.70, 95%CI = 1.03-2.81, P = 0.037). Subgroup analysis showed that Lp(a) elevations increased cardiovascular risk when LDL-C ≥ 1.4 mmol/L. However, this correlation no longer existed when LDL-C levels were very low (< 1.4 mmol/L) (MACE: HR = 0.49, 95%CI = 0.17-1.42, P = 0.186; ACE: HR = 0.68, 95%CI = 0.18-2.61, P = 0.570).
conclusionsLp(a) elevations are associated with recurrent cardiovascular events when LDL-C levels are high, but this association may change when LDL-C levels are extremely low. CAD patients with combination of LDL-C ≥ 1.4 mmol/L and Lp(a) elevations shall be considered as high-risk groups and require further medication for the reduction of their LDL-C levels.
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