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Risk of cardiovascular disease with lipoprotein(a) in familial hypercholesterolemia: a review

Jun Watanabe1, Masato Hamasaki1, Kazuhiko Kotani1

  • 1Division of Community and Family Medicine, Jichi Medical University, Shimotsuke-City, Japan.

Archives of Medical Sciences. Atherosclerotic Diseases
|August 25, 2020
PubMed

Insights

High lipoprotein(a) (Lp[a]) levels significantly increase cardiovascular disease (CVD) risk in familial hypercholesterolemia (FH) patients. Monitoring Lp[a] alongside LDL-C is crucial for managing CVD risk in FH.

Area of Science:

  • Cardiology
  • Genetics
  • Public Health

Background:

  • Lipoprotein(a) (Lp[a]) is a known risk factor for cardiovascular disease (CVD).
  • Familial hypercholesterolemia (FH) is characterized by elevated low-density lipoprotein cholesterol (LDL-C) and is also a CVD risk factor.
  • The interplay between Lp[a] and CVD risk specifically within FH populations requires further elucidation.

Purpose of the Study:

  • To systematically review and meta-analyze existing studies on the association between Lp[a] levels and CVD risk in individuals with FH.
  • To quantify the predictive value of high Lp[a] for CVD events in the FH cohort.

Main Methods:

  • A comprehensive literature search was conducted using PubMed for studies published up to 2020.
  • Eligible studies reporting on Lp[a] and CVD in FH subjects were included.
  • Meta-analyses were performed on cross-sectional and cohort studies.

Main Results:

  • Eight studies met the inclusion criteria.
  • High Lp[a] was significantly associated with increased CVD risk in both cross-sectional (OR=2.57) and cohort (HR=1.91) studies.
  • The integrated relative risk for CVD associated with high Lp[a] in FH was 1.97 (95% CI: 1.57-2.46).

Conclusions:

  • Individuals with FH and elevated Lp[a] levels face a substantial risk of developing CVD.
  • Lp[a] should be considered a critical risk marker in FH management, in addition to LDL-C.
  • Clinical attention to Lp[a] levels can aid in refining CVD risk stratification and prevention strategies for FH patients.
Abstract

Keywords:
apoprotein(a)coronary artery diseasecoronary heart disease

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