Lipoprotein(a) and Increased Cardiovascular Risk in Women.

Area of Science:

• Cardiology
• Preventive Medicine
• Genetics

Background:

• Elevated lipoprotein(a) (Lp[a]) affects 20% of the population, significantly increasing cardiovascular disease (CVD) risk, especially in women.
• Many women with normal traditional risk factors may have high CVD risk due to elevated Lp(a).

Purpose of the Study:

• To investigate the prevalence of elevated Lp(a) in women attending Heart Centers for Women.
• To assess the discordance between Lp(a) and traditional cardiovascular risk markers like LDL-C and ASCVD risk scores.
• To determine if Lp(a) identifies additional women who meet treatment thresholds.

Main Methods:

• A retrospective cross-sectional study analyzed 713 female patients.
• Discordance between low-density lipoprotein cholesterol (LDL-C) and Lp(a) was assessed.
• Ascertained agreement between ASCVD risk, Reynolds Risk Score A (RRS-A), and Reynolds Risk Score B (RRS-B) for treatment thresholds.

Main Results:

• 41% of women had elevated Lp(a), with weak correlation to LDL-C (r=0.08).
• Significant discordance was found between abnormal LDL-C and Lp(a) levels.
• While ASCVD risk estimation identified more patients for treatment, RRS-A identified nearly 1 in 20 patients not identified by ASCVD risk alone.

Conclusions:

• Elevated Lp(a) is highly prevalent in women presenting to specialized heart centers.
• Lp(a) can identify women at high cardiovascular risk who may be missed by traditional risk assessment tools.
• Identifying elevated Lp(a) can guide aggressive risk-factor modification and pharmacologic therapy decisions.