Lipoprotein(a) levels in Irish subjects from a specialised lipid centre

Lipoprotein(a) is a low-density lipoprotein-like particle covalently bound to apolipoprotein(a). It exhibits pro-atherogenic and pro-inflammatory effects and is an established independent monogenic determinant of atherosclerotic cardiovascular disease and aortic valve stenosis [1-4].

To establish the Lp(a) distribution in a native Irish population and to explore if a certain lipid profile was associated with high Lp(a) level.

We retrospectively included all subjects with Lp(a) results tested in our laboratory between January 2021 and December 2022. Patients were divided into Irish and non-Irish name subgroups [16]. We analysed the Lp(a) distribution across lipidaemic subgroups. Statistical analyses were completed in Jamovi programme V2.3.26.

In total 2762 patients of which 1899 had also a lipid profile. Eighty-five percent (n = 2359) of individuals had Irish surnames and 60% (n = 1419) were males. Mean age of all patients was 56 ± 17 years. The median lipoprotein(a) level was 34.5 nmol/L (interquartile interval < 20 to 153). The Lp(a) median in females was 37.3 (interquartile interval < 20 to 169) versus males 32.9 (interquartile interval < 20 to 147) (p = 0.029). A total of 62.9% (n = 1738) of Irish subjects had Lp(a) levels < 75 nmol/L, 7.56% of them (n = 209) between 75 and 125 nmol/L and 29.5% (n = 815) of subjects had Lp(a) > 125 nmol/L.

This is the largest study of Lp(a) distribution in an Irish population revealing positively skewed Lp(a) serum levels. This is not entirely reflective of the general population but brings to the fore the additional hidden high risks in those patients attending cardiovascular services. More education is needed to increase the use of Lp(a) measurements and guide further therapy.