Proposing new lipoprotein (a) cut off value for Kazakhstan: pilot study.

Area of Science:

• Cardiology
• Genetics
• Epidemiology

Background:

• Lipoprotein(a) (Lp(a)) is a recognized risk factor for atherosclerotic cardiovascular diseases (ASCVD) and aortic valve stenosis.
• Current clinical guidelines suggest threshold levels for Lp(a) at 30 mg/dL or 50 mg/dL, but consensus is lacking.
• Optimal Lp(a) thresholds may vary across different ethnic populations.

Purpose of the Study:

• To estimate the specific cut-off value of Lp(a) associated with ASCVD risk in the Central Asian, specifically Kazakhstani, population.
• To investigate the relationship between Lp(a) levels and other cardiovascular risk factors in this population.
• To determine if existing international Lp(a) thresholds are applicable to Kazakhstani individuals.

Main Methods:

• A study involving 487 patients from the National Research Cardiac Surgery Center in Kazakhstan.
• Bivariate and multivariable logistic regression analyses were employed to assess risk factors and Lp(a) levels.
• The Youden index was utilized to predict the threshold value of Lp(a).

Main Results:

• The identified Lp(a) cut-off value for atherosclerotic CVD and aortic valve calcification risk in the Kazakhstani population was 21.1 mg/dL (p < 0.05).
• No significant relationship was observed between Lp(a) levels and low-density lipoprotein cholesterol (LDL-C).
• This suggests Lp(a) acts as an independent risk factor for ASCVD in this cohort.

Conclusions:

• The study establishes a novel, lower Lp(a) threshold (21.2 mg/dL) for cardiovascular risk in the Kazakhstani population.
• These findings indicate that international Lp(a) cutoffs may not be universally applicable to Central Asian populations.
• Further research with larger sample sizes is recommended to validate and refine region-specific Lp(a) thresholds.