Lipoprotein(a) selectively associates with vulnerable coronary plaque phenotypes in comparison with other established
Rebecca Fisher1, Chen Gurevitz2,3, Edward A Fisher1
1Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Aims:
Lipoprotein(a) [Lp(a)] is an inherited cardiovascular risk factor. However, its association with coronary plaque characteristics beyond traditional risk enhancers remains unclear. We aimed to evaluate the association between Lp(a) levels and coronary plaque characteristics in asymptomatic primary prevention patients, and to compare its predictive value against other risk enhancers, including LDL particle concentration (LDL-P), high-sensitivity C-reactive protein (hsCRP), and coronary artery calcium (CAC) score.
Methods And Results:
We retrospectively analysed 547 asymptomatic patients undergoing coronary computed tomography angiography (CCTA) between 2018 and 2024. Plaque characteristics were assessed using artificial intelligence-based quantitative CCTA. Associations between Lp(a), LDL-P, hsCRP, CAC score, and plaque features were evaluated using multivariable regression adjusted for age and sex. Median age was 56 years, 69.8% were male. Higher Lp(a) was associated with greater total plaque volume (β=23.1 mm³, P = 0.006), calcified plaque (β=11.1 mm³, P = 0.014), non-calcified plaque (β=12.0 mm³, P = 0.027), and low-density non-calcified plaque (LDNCP; β=0.4 mm³, P < 0.001) volumes, as well as increased area stenosis (β=1.9%, P = 0.031) and remodelling index (β=0.02, P = 0.017). In multivariable models, CAC score was the strongest predictor of overall plaque burden, including calcified and non-calcified plaque (P < 0.000), but was not associated with LDNCP. Lp(a) remained independently associated with LDNCP (β=0.45 mm³, P = 0.013), while LDL-P and hsCRP showed no significant associations.
Conclusion:
In asymptomatic primary prevention patients, Lp(a) was independently associated with high-risk coronary plaque features, specifically LDNCP, beyond traditional risk enhancers. These findings highlight the unique role of Lp(a) in identifying coronary plaque vulnerability and suggest complementary roles for Lp(a) and CAC in refining cardiovascular risk stratification.
More Related Videos
11:10High-throughput Assay to Phenotype Salmonella enterica Typhimurium Association, Invasion, and Replication in Macrophages
Published on: August 11, 2014
10:03Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Related Concept Videos
Pharmacokinetic Models: Comparison and Selection Criterion
Physiological models take a detailed approach by considering specific molecular processes. They can predict drug distribution, metabolism, and elimination changes, providing a comprehensive understanding of how drugs interact with the body.
Frequency-dependent Selection
Relative Risk
The Sense of Self: Reflected Self-Appraisal and Social Comparison
Association Areas of the Cortex
Prefrontal Association Area: This area is located in the frontal lobe and is involved in planning, decision-making, and moderating social behavior. It connects with primary motor areas,...
Associative Learning
Classical conditioning, also known...
