Elevated Lipoprotein(a) Predictor of Recurrent Coronary Heart Disease

WEDNESDAY, June 14, 2023 (HealthDay News) — Elevated lipoprotein(a) (Lp[a]) is a predictor of recurrent coronary heart disease (CHD) in older adults, according to a study published online June 12 in Current Medical Research & Opinion.

Leon A. Simons, M.D., from the University of New South Wales Sydney, and Judith Simons, from St. Vincent’s Hospital, both in Australia, conducted a longitudinal study involving 607 individuals (mean age, 71 years) with prevalent CHD who were followed for 16 years. Lipids and other CHD risk factors were examined at baseline in 1988 to 1989, and the independent contribution of Lp(a) to a further CHD event was assessed.

The researchers identified 399 incident CHD cases. The median Lp(a) was 130 and 105 mg/L in cases and noncases, respectively. Overall, 26 and 19 percent of CHD cases and noncases, respectively, had Lp(a) 300+ mg/L; 18 and 8 percent of cases and noncases, respectively, had Lp(a) 500+ mg/L. Compared with Lp(a) in quintile 1 (<50 mg/L), Lp(a) in quintile 5 (355+ mg/L) significantly predicted recurrent CHD, with a hazard ratio of 1.53, independent of other risk factors. Lp(a) 500+ mg/L versus lower significantly predicted recurrent CHD (hazard ratio, 1.59). Prediction was also significant for Lp(a) 300+ mg/L versus lower (hazard ratio, 1.37).

“Our new results indicate that new therapeutics in development that aim to reduce elevated Lp(a) might help prevent recurrent disease,” Simons said in a statement. “However, the potential clinical benefit of therapy to reduce elevated Lp(a) is yet to be confirmed.”

Novartis Pharmaceuticals provided an educational grant in support of the present analysis; one author disclosed ties to manufacturers of lipid-modifying drugs.