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Lipoprotein(a) Augments Coronary Risk Estimation in Type 2 Diabetes: A Cross-sectional Study.
Sonali Sharma1, Ramesh Kumar Chandak2, Krishna Kumar Sharma3
1Senior Professor, Department of Biochemistry, RUHS College of Medical Sciences, Jaipur, Rajasthan, India, Orcid: https://orcid.org/0000-0001-5514-1618, Corresponding Author.
The Journal of the Association of Physicians of India
|March 12, 2026
Summary
Adding lipoprotein(a) [Lp(a)] to risk calculators significantly improves coronary heart disease (CHD) risk prediction in type 2 diabetes (T2D) patients. The European Atherosclerosis Society (EAS) algorithm with Lp(a) offers the most robust estimate, enhancing risk stratification.
Area of Science:
- Cardiology
- Endocrinology
- Biochemistry
Background:
- Type 2 diabetes (T2D) is associated with increased coronary heart disease (CHD) risk.
- Existing risk estimation tools for CHD in T2D patients show variability.
- Lipoprotein(a) [Lp(a)] is an emerging biomarker for cardiovascular risk.
Purpose of the Study:
- To evaluate the augmentation of CHD risk prediction in T2D patients by adding Lp(a) to existing risk algorithms.
- To compare the performance of multiple risk calculators with and without Lp(a).
Main Methods:
- A pilot study included 90 T2D patients.
- Clinical and biochemical data, including Lp(a) levels (ELISA), were collected.
- CHD risk was calculated using Framingham, QRISK-3, SCORE-2D, INTERHEART, and EAS algorithms, with and without Lp(a).
Main Results:
- The European Atherosclerosis Society (EAS) algorithm demonstrated the most robust risk estimate.
- Incorporating Lp(a) into risk algorithms significantly improved risk stratification.
- Adding Lp(a) to the EAS algorithm increased risk reclassification by 4.6-19.3%.
Conclusions:
- Significant variation exists in CHD risk prediction among different algorithms in T2D.
- The EAS algorithm, augmented with Lp(a), provides a more accurate risk assessment.
- Larger prospective studies are needed to confirm these pilot findings.
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