Lipoprotein(a) is linked to atherothrombosis and aortic valve stenosis independent of C-reactive protein

Peter E Thomas; Signe Vedel-Krogh; Pia R Kamstrup; Børge G Nordestgaard

doi:10.1093/eurheartj/ehad055

Lipoprotein(a) is linked to atherothrombosis and aortic valve stenosis independent of C-reactive protein

Peter E Thomas, Signe Vedel-Krogh, Pia R Kamstrup, Børge G Nordestgaard

59 Citationer (Scopus)

Abstract

Aims: Recent evidence suggest that the lipoprotein(a)-associated risk of atherosclerotic cardiovascular disease (ASCVD) may be observed only in individuals with low-grade systemic inflammation. It was hypothesized that high lipoprotein(a) is a main driver for the risk of ASCVD, myocardial infarction, and aortic valve stenosis irrespective of C-reactive protein levels.

Methods and results: A total of 68 090 individuals from the Copenhagen General Population Study, a prospective cohort study, were included. During a median follow-up of 8.1 years, 5104 individuals developed ASCVD, 2432 myocardial infarction, and 1220 aortic valve stenosis. The risk of ASCVD, myocardial infarction, and aortic valve stenosis increased with higher values of both lipoprotein(a) and C-reactive protein. For individuals with lipoprotein(a) in the 91st-100th percentiles (≥70 mg/dl, ≥147 nmol/l) vs. the 1st-33rd percentiles (≤6 mg/dl, ≤9 nmol/l), the multivariable-adjusted hazard ratio for ASCVD was 1.61 (95% confidence interval 1.43-1.81) for those with C-reactive protein
Conclusion: High lipoprotein(a) was a main driver for the risk of ASCVD, myocardial infarction, and aortic valve stenosis independent of C-reactive protein levels

Originalsprog	Engelsk
Tidsskrift	European Heart Journal
Vol/bind	44
Udgave nummer	16
Sider (fra-til)	1449-1460
Antal sider	12
ISSN	0195-668X
DOI	https://doi.org/10.1093/eurheartj/ehad055
Status	Udgivet - 21 apr. 2023

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@article{e6d8f63a5d584272ab73f1596cb99343,

title = "Lipoprotein(a) is linked to atherothrombosis and aortic valve stenosis independent of C-reactive protein",

abstract = "AIMS: Recent evidence suggest that the lipoprotein(a)-associated risk of atherosclerotic cardiovascular disease (ASCVD) may be observed only in individuals with low-grade systemic inflammation. It was hypothesized that high lipoprotein(a) is a main driver for the risk of ASCVD, myocardial infarction, and aortic valve stenosis irrespective of C-reactive protein levels.METHODS AND RESULTS: A total of 68 090 individuals from the Copenhagen General Population Study, a prospective cohort study, were included. During a median follow-up of 8.1 years, 5104 individuals developed ASCVD, 2432 myocardial infarction, and 1220 aortic valve stenosis. The risk of ASCVD, myocardial infarction, and aortic valve stenosis increased with higher values of both lipoprotein(a) and C-reactive protein. For individuals with lipoprotein(a) in the 91st-100th percentiles (≥70 mg/dl, ≥147 nmol/l) vs. the 1st-33rd percentiles (≤6 mg/dl, ≤9 nmol/l), the multivariable-adjusted hazard ratio for ASCVD was 1.61 (95\% confidence interval 1.43-1.81) for those with C-reactive protein <2 mg/l and 1.57 (1.36-1.82) for those with C-reactive protein ≥2 mg/l (P for interaction = 0.87). The corresponding values were 2.08 (1.76-2.45) and 1.65 (1.34-2.04) for myocardial infarction, and 2.01 (1.59-2.55) and 1.73 (1.31-2.27) for aortic valve stenosis, respectively (P for interaction = 0.15 and = 0.18). The highest absolute 10-year risks were found in men aged 70-79 years with lipoprotein(a) levels in the 91st-100th percentiles and C-reactive protein ≥2 mg/l, with 34\% for ASCVD, 19\% for myocardial infarction, and 13\% for aortic valve stenosis. The corresponding values in women were 20\%, 10\%, and 8\%, respectively.CONCLUSION: High lipoprotein(a) was a main driver for the risk of ASCVD, myocardial infarction, and aortic valve stenosis independent of C-reactive protein levels.",

keywords = "Male, Humans, Female, C-Reactive Protein, Lipoprotein(a), Prospective Studies, Risk Factors, Aortic Valve Stenosis/epidemiology, Myocardial Infarction/epidemiology, Atherosclerosis/epidemiology, Aortic Valve",

author = "Thomas, \{Peter E\} and Signe Vedel-Krogh and Kamstrup, \{Pia R\} and Nordestgaard, \{B{\o}rge G\}",

note = "{\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: [email protected].",

year = "2023",

month = apr,

day = "21",

doi = "10.1093/eurheartj/ehad055",

language = "English",

volume = "44",

pages = "1449--1460",

journal = "European Heart Journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "16",

}

TY - JOUR

T1 - Lipoprotein(a) is linked to atherothrombosis and aortic valve stenosis independent of C-reactive protein

AU - Thomas, Peter E

AU - Vedel-Krogh, Signe

AU - Kamstrup, Pia R

AU - Nordestgaard, Børge G

PY - 2023/4/21

Y1 - 2023/4/21

N2 - AIMS: Recent evidence suggest that the lipoprotein(a)-associated risk of atherosclerotic cardiovascular disease (ASCVD) may be observed only in individuals with low-grade systemic inflammation. It was hypothesized that high lipoprotein(a) is a main driver for the risk of ASCVD, myocardial infarction, and aortic valve stenosis irrespective of C-reactive protein levels.METHODS AND RESULTS: A total of 68 090 individuals from the Copenhagen General Population Study, a prospective cohort study, were included. During a median follow-up of 8.1 years, 5104 individuals developed ASCVD, 2432 myocardial infarction, and 1220 aortic valve stenosis. The risk of ASCVD, myocardial infarction, and aortic valve stenosis increased with higher values of both lipoprotein(a) and C-reactive protein. For individuals with lipoprotein(a) in the 91st-100th percentiles (≥70 mg/dl, ≥147 nmol/l) vs. the 1st-33rd percentiles (≤6 mg/dl, ≤9 nmol/l), the multivariable-adjusted hazard ratio for ASCVD was 1.61 (95% confidence interval 1.43-1.81) for those with C-reactive protein <2 mg/l and 1.57 (1.36-1.82) for those with C-reactive protein ≥2 mg/l (P for interaction = 0.87). The corresponding values were 2.08 (1.76-2.45) and 1.65 (1.34-2.04) for myocardial infarction, and 2.01 (1.59-2.55) and 1.73 (1.31-2.27) for aortic valve stenosis, respectively (P for interaction = 0.15 and = 0.18). The highest absolute 10-year risks were found in men aged 70-79 years with lipoprotein(a) levels in the 91st-100th percentiles and C-reactive protein ≥2 mg/l, with 34% for ASCVD, 19% for myocardial infarction, and 13% for aortic valve stenosis. The corresponding values in women were 20%, 10%, and 8%, respectively.CONCLUSION: High lipoprotein(a) was a main driver for the risk of ASCVD, myocardial infarction, and aortic valve stenosis independent of C-reactive protein levels.

AB - AIMS: Recent evidence suggest that the lipoprotein(a)-associated risk of atherosclerotic cardiovascular disease (ASCVD) may be observed only in individuals with low-grade systemic inflammation. It was hypothesized that high lipoprotein(a) is a main driver for the risk of ASCVD, myocardial infarction, and aortic valve stenosis irrespective of C-reactive protein levels.METHODS AND RESULTS: A total of 68 090 individuals from the Copenhagen General Population Study, a prospective cohort study, were included. During a median follow-up of 8.1 years, 5104 individuals developed ASCVD, 2432 myocardial infarction, and 1220 aortic valve stenosis. The risk of ASCVD, myocardial infarction, and aortic valve stenosis increased with higher values of both lipoprotein(a) and C-reactive protein. For individuals with lipoprotein(a) in the 91st-100th percentiles (≥70 mg/dl, ≥147 nmol/l) vs. the 1st-33rd percentiles (≤6 mg/dl, ≤9 nmol/l), the multivariable-adjusted hazard ratio for ASCVD was 1.61 (95% confidence interval 1.43-1.81) for those with C-reactive protein <2 mg/l and 1.57 (1.36-1.82) for those with C-reactive protein ≥2 mg/l (P for interaction = 0.87). The corresponding values were 2.08 (1.76-2.45) and 1.65 (1.34-2.04) for myocardial infarction, and 2.01 (1.59-2.55) and 1.73 (1.31-2.27) for aortic valve stenosis, respectively (P for interaction = 0.15 and = 0.18). The highest absolute 10-year risks were found in men aged 70-79 years with lipoprotein(a) levels in the 91st-100th percentiles and C-reactive protein ≥2 mg/l, with 34% for ASCVD, 19% for myocardial infarction, and 13% for aortic valve stenosis. The corresponding values in women were 20%, 10%, and 8%, respectively.CONCLUSION: High lipoprotein(a) was a main driver for the risk of ASCVD, myocardial infarction, and aortic valve stenosis independent of C-reactive protein levels.

KW - Male

KW - Humans

KW - Female

KW - C-Reactive Protein

KW - Lipoprotein(a)

KW - Prospective Studies

KW - Risk Factors

KW - Aortic Valve Stenosis/epidemiology

KW - Myocardial Infarction/epidemiology

KW - Atherosclerosis/epidemiology

KW - Aortic Valve

UR - https://www.scopus.com/pages/publications/85164334499

U2 - 10.1093/eurheartj/ehad055

DO - 10.1093/eurheartj/ehad055

M3 - Journal article

C2 - 36805188

SN - 0195-668X

VL - 44

SP - 1449

EP - 1460

JO - European Heart Journal

JF - European Heart Journal

IS - 16

ER -

Lipoprotein(a) is linked to atherothrombosis and aortic valve stenosis independent of C-reactive protein

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