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Lipoprotein(a) levels and cardiovascular mortality risk in Chinese patients undergoing hemodialysis
Qiaojing Liang1, Guojuan Zhang2, Liping Jiang1
1Department of Nephrology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Insights
High lipoprotein(a) (Lp(a)) levels significantly increase cardiovascular disease (CVD) and all-cause mortality in Chinese patients on maintenance hemodialysis (MHD). This highlights Lp(a) as a critical risk factor in this vulnerable population.
Area of Science:
- Nephrology
- Cardiology
- Clinical Biochemistry
Background:
- Lipoprotein(a) (Lp(a)) is an established independent risk factor for cardiovascular disease (CVD) in the general population.
- The specific impact of Lp(a) on CVD mortality in Chinese patients undergoing maintenance hemodialysis (MHD) remains incompletely understood.
Purpose of the Study:
- To investigate the association between serum Lp(a) levels and both CVD mortality and all-cause mortality in Chinese patients on MHD.
- To establish Lp(a) as a potential risk marker in this specific patient cohort.
Main Methods:
- A retrospective cohort study involving 200 MHD patients from Beijing Tongren Hospital.
- Analysis of mortality outcomes (CVD-related and all-cause) over a median follow-up of 66.5 months.
- Kaplan-Meier survival analysis, multivariable Cox regression, and restricted cubic spline models were employed to assess Lp(a) associations.
Main Results:
- A total of 121 deaths occurred (60.5%), with 66 (54.5%) attributed to CVD.
- Patients with the highest Lp(a) levels exhibited significantly lower survival rates for both CVD and all-cause mortality.
- Higher Lp(a) levels were independently associated with increased risks of CVD and all-cause mortality, with a dose-response relationship observed.
Conclusions:
- Elevated serum Lp(a) levels are a significant independent predictor of increased CVD and all-cause mortality in Chinese MHD patients.
- Serum Lp(a) warrants consideration as a crucial risk factor for cardiovascular mortality in patients undergoing maintenance hemodialysis.
Purpose:
Lipoprotein(a) (Lp(a)) is recognized as an independent risk factor for cardiovascular disease (CVD) in the general population. However, its impact on CVD mortality among Chinese patients undergoing maintenance hemodialysis (MHD) has not been fully established. This study aimed to evaluate the association between Lp(a) levels and both CVD mortality and all-cause mortality in this population.
Methods:
A retrospective cohort study was conducted involving 200 MHD patients from Beijing Tongren Hospital, analyzed from January 1, 2013, to July 1, 2024. The mortality outcomes included CVD-related and all-cause mortality. Kaplan-Meier survival curves were utilized to assess the impact of Lp(a), while Cox regression analysis and restrict cubic spline were performed to explore associations.
Results:
The median follow-up duration was 66.5 months, with 121 deaths recorded (60.5%), of which 66 (54.5%) were due to CVD. Kaplan-Meier analysis indicated that patients in the highest tertile of Lp(a) levels had the lowest survival for both CVD mortality and all-cause mortality. In multivariable Cox regression, higher Lp(a) levels were independently associated with an increased risk of both CVD mortality and all-cause mortality. The restricted cubic splines regression model showed that the risk of CVD mortality and all-cause mortality increased with rising Lp(a) levels.
Conclusion:
Elevated serum Lp(a) levels are independently associated with increased mortality from both CVD and all causes in Chinese MHD patients. These findings indicate that serum Lp(a) may be a significant risk factor for CVD mortality in this population.
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