TY - JOUR
T1 - Lipoprotein(a) levels in a global population with established atherosclerotic cardiovascular disease
AU - Nissen, Steven E
AU - Wolski, Kathy
AU - Cho, Leslie
AU - Nicholls, Stephen J
AU - Kastelein, John
AU - Leitersdorf, Eran
AU - Landmesser, Ulf
AU - Blaha, Michael
AU - Lincoff, A Michael
AU - Morishita, Ryuichi
AU - Tsimikas, Sotirios
AU - Liu, Junhao
AU - Manning, Brian
AU - Kozlovski, Plamen
AU - Lesogor, Anastasia
AU - Thuren, Tom
AU - Shibasaki, Taro
AU - Matei, Florin
AU - Silveira, Fábio Serra
AU - Meunch, Andreas
AU - Bada, Aysha
AU - Vijan, Vinod
AU - Bruun, Niels Eske
AU - Nordestgaard, Borge G
AU - Lp(a)HERITAGE Investigators
N1 - © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/10
Y1 - 2022/10
N2 - OBJECTIVE: Lipoprotein(a) (Lp(a)) is an important genetically determined risk factor for atherosclerotic vascular disease (ASCVD). With the development of Lp(a)-lowering therapies, this study sought to characterise patterns of Lp(a) levels in a global ASCVD population and identify racial, ethnic, regional and gender differences.METHODS: A multicentre cross-sectional epidemiological study to estimate the prevalence of elevated Lp(a) in patients with a history of myocardial infarction, ischaemic stroke or peripheral artery disease conducted at 949 sites in 48 countries in North America, Europe, Asia, South America, South Africa and Australia between April 2019 and July 2021. Low-density lipoprotein cholesterol (LDL-C) and Lp(a) levels were measured either as mass (mg/dL) or molar concentration (nmol/L).RESULTS: Of 48 135 enrolled patients, 13.9% had prior measurements of Lp(a). Mean age was 62.6 (SD 10.1) years and 25.9% were female. Median Lp(a) was 18.0 mg/dL (IQR 7.9-57.1) or 42.0 nmol/L (IQR 15.0-155.4). Median LDL-C was 77 mg/dL (IQR 58.4-101.0). Lp(a) in women was higher, 22.8 (IQR 9.0-73.0) mg/dL, than in men, 17.0 (IQR 7.1-52.2) mg/dL, p<0.001. Black patients had Lp(a) levels approximately threefold higher than white, Hispanic or Asian patients. Younger patients also had higher levels. 27.9% of patients had Lp(a) levels >50 mg/dL, 20.7% had levels >70 mg/dL, 12.9% were >90 mg/dL and 26.0% of patients exceeded 150 nmol/L.CONCLUSIONS: Globally, Lp(a) is measured in a small minority of patients with ASCVD and is highest in black, younger and female patients. More than 25% of patients had levels exceeding the established threshold for increased cardiovascular risk, approximately 50 mg/dL or 125 nmol/L.
AB - OBJECTIVE: Lipoprotein(a) (Lp(a)) is an important genetically determined risk factor for atherosclerotic vascular disease (ASCVD). With the development of Lp(a)-lowering therapies, this study sought to characterise patterns of Lp(a) levels in a global ASCVD population and identify racial, ethnic, regional and gender differences.METHODS: A multicentre cross-sectional epidemiological study to estimate the prevalence of elevated Lp(a) in patients with a history of myocardial infarction, ischaemic stroke or peripheral artery disease conducted at 949 sites in 48 countries in North America, Europe, Asia, South America, South Africa and Australia between April 2019 and July 2021. Low-density lipoprotein cholesterol (LDL-C) and Lp(a) levels were measured either as mass (mg/dL) or molar concentration (nmol/L).RESULTS: Of 48 135 enrolled patients, 13.9% had prior measurements of Lp(a). Mean age was 62.6 (SD 10.1) years and 25.9% were female. Median Lp(a) was 18.0 mg/dL (IQR 7.9-57.1) or 42.0 nmol/L (IQR 15.0-155.4). Median LDL-C was 77 mg/dL (IQR 58.4-101.0). Lp(a) in women was higher, 22.8 (IQR 9.0-73.0) mg/dL, than in men, 17.0 (IQR 7.1-52.2) mg/dL, p<0.001. Black patients had Lp(a) levels approximately threefold higher than white, Hispanic or Asian patients. Younger patients also had higher levels. 27.9% of patients had Lp(a) levels >50 mg/dL, 20.7% had levels >70 mg/dL, 12.9% were >90 mg/dL and 26.0% of patients exceeded 150 nmol/L.CONCLUSIONS: Globally, Lp(a) is measured in a small minority of patients with ASCVD and is highest in black, younger and female patients. More than 25% of patients had levels exceeding the established threshold for increased cardiovascular risk, approximately 50 mg/dL or 125 nmol/L.
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Atherosclerosis/diagnosis
KW - Brain Ischemia
KW - Cardiovascular Diseases
KW - Cholesterol, LDL
KW - Cross-Sectional Studies
KW - Lipoprotein(a)
KW - Stroke
KW - Aged
UR - http://www.scopus.com/inward/record.url?scp=85142157830&partnerID=8YFLogxK
U2 - 10.1136/openhrt-2022-002060
DO - 10.1136/openhrt-2022-002060
M3 - Journal article
C2 - 36252994
VL - 9
JO - Open Heart
JF - Open Heart
SN - 2053-3624
IS - 2
M1 - 002060
ER -