High Lp(a) levels increase risk of repeat cardiovascular events—LDL drugs may help
High levels of lipoprotein(a), also known as Lp(a), significantly increase a person’s risk of recurrent adverse cardiovascular events, according to new data published in European Heart Journal.[1]
The study, believed to be the largest of its kind, was independently funded by the Family Heart Foundation (FHF), a patient advocacy group focused on improving care for patients with elevated Lp(a) levels and familial hypercholesterolemia.
Researchers evaluated data from more than 273,000 patients with atherosclerotic cardiovascular disease (ASCVD), following their health for a median of 5.4 years. Overall, patients with the highest levels of Lp(a) were 40% more likely to have a recurrent adverse cardiovascular event such as a myocardial infarction or ischemic stroke. Other adverse events evaluated in the study included percutaneous coronary intervention and coronary artery bypass graft procedures.
“Among the many important findings in this study, we now know that in people living with cardiovascular disease, every nmol/L of Lp(a) confers increased risk of a subsequent cardiovascular event,” first author Diane MacDougall, vice president of science and research for the FHF, said in a statement. “This is a meaningful advancement in our understanding of the impact of Lp(a) on one's health. The results further show that the risk increases regardless of what type of cardiovascular disease individuals had initially (in the heart, brain or legs), whether or not they also had diabetes, or their sex or race/ethnicity. The higher the Lp(a) level, the more likely people living with ASCVD are to have another cardiovascular event.”
“While previous smaller studies have shown that the risk of cardiovascular events can increase within certain ranges of Lp(a), this is the first study to show that the risks of cardiovascular events including heart attack, stroke and cardiac surgeries continue to increase across all ascending levels of Lp(a) and that there is no indication that the risk plateaus,” added Katherine Wilemon, founder and CEO of the FHF. “The United States has lagged behind many other countries in recommending that adults complete a simple blood test to measure Lp(a). This study strongly confirms the importance of considering Lp(a) levels among other risk factors when determining an individual's risk of future heart attacks and strokes.”
Another key takeaway from this study was the fact that medications designed to lower a patient’s LDL cholesterol—high-dose statins and PCSK9 inhibitors, for example—showed potential to help limit some of these risks.
No pharmaceutical treatment options that target high Lp(a) levels are currently on the market, but it remains a topic cardiologists are focused on moving forward. Click here to read a Cardiovascular Business on this very topic with Deepak L. Bhatt, MD, director of Mount Sinai Fuster Heart Hospital and the Dr. Valentin Fuster Professor of Cardiovascular Medicine at the Icahn School of Medicine at Mount Sinai.
The full European Heart Journal study is available here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.