Lipoprotein(a) and subclinical coronary atherosclerosis in asymptomatic individuals. (May 2022)

• Record Type: Journal Article
• Authors: Lee, Hyeji; Park, Kyung Sun; Jeon, Young-Jee; Park, Eun Ji; Park, Sangwoo; Ann, Soe Hee; Kim, Yong-Giun; Lee, Yongjik; Choi, Seong Hoon; Park, Gyung-Min
• Is Part Of: Atherosclerosis. Volume 349(2022)
• Page Start: 190
• Page End: 195
• Publication Date: 2022-05
• Subjects: Lipoprotein(a) -- Coronary artery disease -- Atherosclerosis -- Heart disease risk factors -- Coronary computed tomography angiography; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2021.09.027
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: There are limited data regarding the association between lipoprotein(a) (Lp[a]) and subclinical coronary atherosclerosis. This study investigated the association between Lp(a) and subclinical coronary atherosclerosis detected by coronary computed tomographic angiography (CCTA) in an asymptomatic population. Methods: We retrospectively analyzed 7201 asymptomatic individuals (mean age 54.4 ± 7.9 years; 65.3% men with no prior history of coronary artery disease who voluntarily underwent CCTA as part of a general health examination). The degree and extent of subclinical coronary atherosclerosis were evaluated by CCTA. Study participants were stratified into quartiles according to their Lp(a) levels (<4.3, 4.3–8.9, 9.0–20.1, and ≥20.2 mg/dL). Results: Of the study participants, any coronary plaque on CCTA was observed in 2557 (35.5%). Specifically, calcified, non-calcified, and mixed plaques were observed in 2411 (33.5%), 363 (5.0%) and 249 (3.5%) participants, respectively. After adjustment for the presence of cardiovascular risk factors, the fourth Lp(a) quartile was significantly associated with any coronary (odds ratio [OR] 1.212; 95% confidence interval [CI] 1.038–1.416), calcified (1.205, 95% CI 1.030–1.410), non-calcified (1.588, 95% CI 1.152–2.189), or mixed (1.674, 95% CI 1.172–2.391) plaque compared with the first Lp(a) quartile. In addition, 442 (6.1%) had significant coronary artery stenosis (≥50% diameter stenosis). The odds ratio for significant stenosis (1.537, 95% CI 1.153–2.048) was higher in the fourth quartile compared with the first quartile. Conclusions: In this large cross-sectional study with asymptomatic individuals undergoing CCTA, higher Lp(a) level was associated with subclinical coronary atherosclerosis. Graphical abstract: Image 1 Highlights: The prevention of adverse coronary artery disease events in asymptomatic subjects is a major public health concern. Elevated lipoprotein(a) [Lp(a)] level is significantly associated with subclinical coronary atherosclerosis. Therefore, appropriate strategies for managing Lp(a) are needed even in asymptomatic subjects.