Comparison of Lipoprotein(a) levels between elderly and middle-aged men with coronary artery disease

Area of Science:

• Cardiovascular Medicine
• Atherosclerosis Research
• Geriatric Cardiology

Background:

• Lipoprotein(a) [Lp(a)] is an established risk factor for atherosclerotic disease, particularly in middle-aged men.
• The role of Lp(a)] in cardiovascular risk for women and the elderly remains less defined.
• Previous research indicates excess Lp(a)] may not correlate with increased risk in individuals over 65.

Purpose of the Study:

• To investigate the association between Lp(a)] levels and coronary artery disease (CAD) in distinct age groups of men.
• To determine if Lp(a)] is an independent risk factor for premature CAD in middle-aged men compared to older men.
• To evaluate the clinical utility of Lp(a)] in predicting CAD risk across different age demographics in men.

Main Methods:

• Study population comprised men <65 years (n=108) and >65 years (n=66) with angiographically confirmed significant coronary artery narrowing.
• Serum Lp(a)] concentrations were measured in all participants.
• Statistical analysis, including adjusted odds ratios (OR), was used to assess the association between elevated Lp(a)] and CAD in each age group.

Main Results:

• Elevated Lp(a)] showed a positive association with CAD in men <65 years (adjusted OR: 2.45, P <0.05).
• No significant association was found between elevated Lp(a)] and CAD in men >65 years (adjusted OR: 0.56, P = NS).
• These findings indicate Lp(a)] is an independent risk factor for premature CAD in middle-aged men, with its predictive importance decreasing with age.

Conclusions:

• Elevated Lp(a)] is a significant independent risk factor for premature coronary artery disease in middle-aged men.
• The predictive value of Lp(a)] for CAD risk appears to decrease substantially in men over 65.
• Assessing Lp(a)] levels alone has limited utility for predicting CAD risk in older men; comprehensive evaluation of traditional risk factors is essential.