Lipoprotein(a) molar concentrations help inform cardiovascular risk

The risk of coronary artery disease (CAD) can be predicted by a single accurate measurement of lipoprotein(a) molar concentration if therapies substantially altering lipoprotein(a) are not present, suggests a recent study.

In this study, the authors analysed the association between baseline and first follow-up measurements of lipoprotein(a) in the UK Biobank (n=16,017 unrelated individuals). They also evaluated the association between change in lipoprotein(a) molar concentration and incident CAD among 15,432 participants using Cox proportional hazards models.

Over a median of 4.42 years, baseline lipoprotein(a) molar concentrations significantly correlated with follow-up levels (Spearman rho, 0.96; p<0.0001). Such association remained stable across time between measurement of <3 (rho, 0.96), 3‒4 (rho, 0.97), 4‒5 (rho, 0.96), and >5 years (rho, 0.96).

Negligible-to-modest associations were observed between use of statins and changes in lipoprotein(a) molar concentration, but statin use correlated with a significant increase in lipoprotein(a) among individuals with baseline levels ≥70 nmol/L.

Of note, follow-up lipoprotein(a) molar concentration was significantly associated with risk of incident CAD (hazard ratio per 120 nmol/L, 1.32, 95 percent confidence interval, 1.16‒1.50; p=0.0002), but the delta between follow-up and baseline concentrations did not significantly correlate with incident PAD independent of follow-up lipoprotein(a) (p=0.98).

“These findings suggest that, in the absence of therapies substantially altering lipoprotein(a), a single accurate measurement of lipoprotein(a) molar concentration is an efficient method to inform CAD risk,” the authors said.