| Title: | Lipoprotein(a) and residual cardiovascular risk in statin-treated patients |
| Journal: | European Journal of Preventive Cardiology |
| Published: | 4 Jun 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42240227/ |
| DOI: | https://doi.org/10.1093/eurjpc/zwag296 |
Publication 19783
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Abstract
AIMS: This study assessed the risk associated with moderately elevated lipoprotein(a) (Lp[a]) levels below current thresholds in a statin-treated population and explored possible differences in the effect of Lp(a) between individuals with and without established atherosclerotic cardiovascular disease (ASCVD).</p>
METHODS: The analysis included 17,376 patients aged ≥45 years with established ASCVD or type 2 diabetes from the UK Biobank. The primary endpoint was major adverse cardiovascular events (MACE), defined as non-fatal myocardial infarction (MI), non-fatal stroke, or cardiovascular (CV) mortality. CV outcomes were compared between lower and upper Lp(a)-tertiles (<12.5 vs. >46.8 nmol/L) using adjusted Poisson regression models. Generalized additive Cox models were used to examine the continuous dose-response relationship between Lp(a) and MACE risk, stratified by baseline ASCVD status.</p>
RESULTS: Compared with the lower Lp(a)-tertile, the upper Lp(a)-tertile was associated with a 20% higher risk of MACE (p<0.01), 27% higher risk of hospitalization for MI (p<0.05), 34% higher rate of coronary revascularization (p<0.001), and a 30% increased CV mortality (p<0.05). Stratified dose-response models showed a more pronounced effect of Lp(a) on MACE risk in individuals without established ASCVD.</p>
CONCLUSION: In a statin-treated population at high CV risk, moderately elevated Lp(a) levels (>46.8 nmol/L) below current guideline thresholds are associated with significantly increased risk of CV events, with a substantially stronger effect observed in those without established ASCVD. These findings suggest that current Lp(a) thresholds may underestimate residual CV risk in statin-treated individuals, particularly those without established ASCVD with high CV risk.</p>
8 Authors
- Sam-Lennart Oftadeh
- Andreas Pütz
- Malte Jacobsen
- Paul Balfanz
- Nikolaus Marx
- Julia Brandts
- Dirk Müller-Wieland
- Marlo Verket
1 Application
| Application ID | Title |
|---|---|
| 734824 | Applicability of the REDUCE-IT trial to UK Biobank |
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