Patient Characteristics Across Lipoprotein(a) Levels: Insights From a Retrospective Study

Area of Science:

• Cardiology
• Genetics
• Biochemistry

Background:

• Elevated plasma lipoprotein(a) (Lp(a)) is a prevalent, causal risk factor for atherosclerotic cardiovascular disease (ASCVD).
• Lp(a) may significantly influence plasma low-density lipoprotein-cholesterol (LDL-C) levels.
• Understanding the relationship between Lp(a) and LDL-C is crucial for cardiovascular risk assessment.

Purpose of the Study:

• To characterize clinical features across varying Lp(a) levels.
• To assess if LDL-C levels reliably indicate underlying elevated Lp(a).
• To determine the proportion of individuals with normal or elevated LDL-C at different Lp(a) concentrations.

Main Methods:

• Retrospective study design.
• Data collected from medical records and the North Denmark Region Clinical Laboratory System (LABKA) I and II (January 2021 - August 2024).
• Inclusion of 1346 individuals with detailed clinical and biochemical data.

Main Results:

• 28.5% of individuals had elevated Lp(a) levels (≥125 nmol/L).
• ASCVD prevalence was 57.7% in patients with Lp(a) ≥400 nmol/L versus 21.1% with Lp(a) <100 nmol/L.
• Median ASCVD onset age was 51 years for Lp(a) ≥400 nmol/L vs. 56 years for Lp(a) <100 nmol/L.
• In individuals with Lp(a) ≥300 nmol/L, 7.6% had LDL-C <3.0 mmol/L and 9.1% had LDL-C 3.0-3.5 mmol/L upon first measurement.
• Increasing Lp(a) levels correlated with increased ASCVD prevalence and decreased age of ASCVD onset.

Conclusions:

• Distinct clinical characteristics are associated with different Lp(a) levels.
• Elevated Lp(a) is linked to increased ASCVD risk and earlier onset.
• Normal LDL-C levels cannot exclude the presence of highly elevated Lp(a).