New Findings on Lp(a) and Heart Disease

A groundbreaking study has unveiled a shocking connection between elevated levels of lipoprotein(a) [Lp(a)] and the risk of recurrent atherosclerotic cardiovascular disease (ASCVD), which includes serious health threats like heart attacks and strokes. But there's a silver lining: intensive LDL cholesterol-lowering therapies may help mitigate this danger!

The Largest Study of Its Kind!

In an extensive analysis within the Family Heart Database, researchers scrutinized data from over 273,000 individuals in the U.S. diagnosed with ASCVD, starting just 30 days post-diagnosis. With such a vast pool of participants, the team meticulously assessed the entire spectrum of Lp(a) levels, particularly those exceeding 175-200 nmol/L.

Diane MacDougall, MS, Vice President of Science at the Family Heart Foundation and lead author, emphasized, "Each nmol/L increase in Lp(a) corresponds to a heightened risk of future cardiovascular events for individuals with CVD. This insight marks a significant leap in our understanding of Lp(a)’s health implications."

Who is Affected?

Elevated Lp(a) levels are known to be a causal risk factor for ASCVD in healthy individuals, cutting across demographics of sex and ethnicity. This study, however, shines a light specifically on how recurrent ASCVD events relate to Lp(a) levels.

Utilizing medical claims data spanning a decade (2012-2022) for a massive 340 million individuals, the analysis identified 273,770 patients with ASCVD and relevant Lp(a) measurements—43% were women, 8% Black, 9% Hispanic, and 59% White.

Key Statistics from the Study

During an average follow-up of 5.4 years, an alarming 15% of participants—41,687 individuals—suffered recurrent ASCVD events. Notably, researchers established a strong correlation: the higher the Lp(a) level, the greater the risk of subsequent cardiovascular incidents.

Comparative statistics revealed that those with Lp(a) levels between 15-79 nmol/L had a 4% increased risk, rising to a staggering 45% for those with levels exceeding 300 nmol/L!

Differences Across Demographics

Interesting discrepancies surfaced across gender and racial lines. Women showed higher average Lp(a) levels compared to men, and Black participants had elevated levels when compared to their Hispanic and White counterparts. At the high end (≥300 nmol/L), Hispanic and Black individuals displayed an even greater propensity for recurrent events compared to White individuals.

Hope on the Horizon!

Encouragingly, the study found that aggressive LDL-C-lowering therapies, particularly with PCSK9 inhibitors, may significantly reduce the risk associated with elevated Lp(a) levels exceeding 180 nmol/L. This could represent a breakthrough for at-risk patients!

A Call to Action!

Katherine Wilemon, CEO of the Family Heart Foundation, pointed out that the U.S. has lagged in advocating for routine Lp(a) blood tests. "This study underscores the crucial need to consider Lp(a) levels in conjunction with other risk factors when evaluating a person's risk for future heart attacks and strokes!" she stated.

As awareness grows, it’s vital for healthcare systems to prioritize Lp(a) testing and ensure that patients understand their risks. Don't let Lp(a) catch you off guard!