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The Association of Lipoprotein(a) Levels with Atherosclerotic Cardiovascular Disease in Thailand: A Cross-Sectional

Lukana Preechasuk1, Tanawan Kongmalai1,2, Varisara Lapinee1,3

  • 1Siriraj Diabetes Center of Excellence, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Vascular Health and Risk Management
|September 29, 2025
PubMed

Insights

A lipoprotein(a) [Lp(a)] level of 40 nmol/L or higher is a significant predictor of atherosclerotic cardiovascular disease (ASCVD) and coronary artery disease (CAD) in Thai patients. This finding helps refine risk assessment for cardiovascular events in this population.

Area of Science:

  • Cardiology
  • Biochemistry
  • Public Health

Background:

  • Lipoprotein(a) [Lp(a)] is a recognized risk factor for atherosclerotic cardiovascular disease (ASCVD).
  • Optimal Lp(a) cutoff levels for predicting ASCVD in Southeast Asian populations, including Thailand, are not well-established.
  • Accurate risk stratification is crucial for effective cardiovascular disease prevention strategies.

Purpose of the Study:

  • To determine the optimal plasma Lp(a) cutoff level for predicting ASCVD in Thai patients.
  • To investigate the association between Lp(a) levels and the risk of ASCVD and coronary artery disease (CAD) in this demographic.
  • To enhance the prediction models for cardiovascular events in Thailand.

Main Methods:

  • Retrospective analysis of 2341 Thai patients who underwent Lp(a) measurement.
  • Comparison of Lp(a) levels between patients with and without ASCVD, including coronary artery disease (CAD), ischemic stroke, peripheral arterial disease (PAD), and abdominal aortic aneurysm.
  • Calculation of odds ratios (OR) for ASCVD and CAD using multivariate logistic regression, adjusting for established risk factors.

Main Results:

  • Median Lp(a) levels were significantly higher in patients with ASCVD, CAD, and aortic stenosis (AS) compared to controls.
  • An Lp(a) cutoff of ≥40 nmol/L was associated with increased risks of ASCVD [OR 1.538] and CAD [OR 1.877] after adjusting for other risk factors.
  • A multivariate model incorporating Lp(a)≥40 nmol/L achieved 70-80% sensitivity and specificity for predicting ASCVD and CAD.

Conclusions:

  • Elevated plasma Lp(a) levels are significantly associated with ASCVD and CAD in Thai patients.
  • An Lp(a) cutoff of ≥40 nmol/L effectively predicts ASCVD and CAD risk in the Thai population.
  • This established cutoff can improve cardiovascular risk assessment and management in Thailand.
Abstract

Keywords:
Asianaortic valve stenosisatherosclerotic cardiovascular diseasecoronary artery diseaselipoprotein(a)

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