Association between lipoprotein (a) and heart failure with reduced ejection fraction development

Area of Science:

• Cardiology
• Biomarkers
• Heart Failure Research

Background:

• Lipoprotein (a) [Lp(a)] is a recognized cardiovascular risk factor.
• The association between baseline Lp(a) levels and the development of heart failure with reduced ejection fraction (HFrEF) requires further investigation.

Purpose of the Study:

• To evaluate the relationship between baseline serum Lp(a) levels and the incidence of HFrEF.
• To identify specific patient subgroups where Lp(a) may confer a greater risk for HFrEF.

Main Methods:

• Retrospective analysis of outpatient clinic data.
• Participants categorized into low Lp(a) (<30 mg/dl) and high Lp(a) (≥30 mg/dl) groups.
• Follow-up via clinical notes review to determine the first diagnosis of HFrEF.

Main Results:

• Higher baseline Lp(a) was associated with male sex, diabetes mellitus (DM), and dyslipidemia.
• Increased Lp(a) correlated positively with N-terminal pro-B natriuretic peptide and negatively with left ventricular ejection fraction (LVEF).
• Each 10 mg/dl increase in baseline Lp(a) significantly predicted HFrEF (OR 1.17; 95% CI 1.05–1.46), with amplified risk in men, DM, and coronary heart disease (CHD) patients, and mitigated risk with beta-blocker use.

Conclusions:

• Elevated baseline Lp(a) is a significant predictor of HFrEF development.
• The atherothrombotic risk associated with Lp(a) is more pronounced in men and individuals with DM or CHD.
• Beta-blocker therapy may attenuate the adverse effects of Lp(a) on HFrEF development, highlighting Lp(a) as a potential novel risk factor.