Is There a Need for Sex-Tailored Lipoprotein(a) Cut-Off Values for Coronary Artery Disease Risk Stratification?

IF 2.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2024-09-12 DOI:10.1002/clc.70012

Ece Yurtseven, Dilek Ural, Erol Gursoy, Bekay Omer Cunedioglu, Orhan Ulas Guler, Kemal Baysal, Saide Aytekin, Vedat Aytekin, Meral Kayakcioglu

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Abstract

Background

Lipoprotein(a) [Lp(a)] plasma level is a well-known risk factor for coronary artery disease (CAD). Existing data regarding the influence of sex on the Lp(a)-CAD relationship are inconsistent.

Objective

To investigate the relationship between Lp(a) and CAD in men and women and to elucidate any sex-specific differences that may exist.

Methods

Data of patients with Lp(a) measurements who were admitted to a tertiary university hospital, Koc University Hospital, were analyzed. The relationship between Lp(a) levels and CAD was explored in all patients and in subgroups created by sex. Two commonly accepted Lp(a) thresholds ≥ 30 and ≥ 50 mg/dL were analyzed.

Results

A total of 1858 patients (mean age 54 ± 17 years; 53.33% females) were included in the analysis. Lp(a) was an independent predictor of CAD according to the multivariate regression model for the entire cohort. In all cohort, both cut-off values (≥ 30 and ≥ 50 mg/dL) were detected as independent predictors of CAD (p < 0.001). In sex-specific analysis, an Lp(a) ≥ 30 mg/dL was an independent predictor of CAD only in women (p < 0.001), but Lp(a) ≥ 50 mg/dL was a CAD predictor both in men and women (men, p = 0.004; women, p = 0.047).

Conclusion

The findings of this study may suggest that different thresholds of Lp(a) level can be employed for risk stratification in women compared to men.

Abstract Image

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在冠状动脉疾病风险分层中，是否需要考虑性别因素的脂蛋白（a）临界值？

背景脂蛋白（a）[Lp（a）]血浆水平是众所周知的冠状动脉疾病（CAD）风险因素。关于性别对脂蛋白（a）与冠状动脉疾病关系的影响，现有数据并不一致。目的研究男性和女性脂蛋白（a）与冠状动脉粥样硬化之间的关系，并阐明可能存在的性别差异。方法分析科克大学医院（Koc University Hospital）这所三级甲等医院收治的 Lp(a) 测量患者的数据。研究了所有患者以及按性别划分的亚组中脂蛋白（a）水平与 CAD 之间的关系。对两种普遍接受的脂蛋白（a）阈值（≥ 30 和 ≥ 50 mg/dL）进行了分析。结果共有 1858 名患者（平均年龄为 54 ± 17 岁；女性占 53.33%）被纳入分析。根据整个队列的多变量回归模型，脂蛋白（a）是预测 CAD 的独立指标。在所有队列中，两个临界值（≥ 30 和 ≥ 50 mg/dL）都是预测 CAD 的独立因素（p < 0.001）。在性别特异性分析中，脂蛋白（a）≥ 30 毫克/分升仅是女性患 CAD 的独立预测因子（p < 0.001），但脂蛋白（a）≥ 50 毫克/分升是男性和女性患 CAD 的预测因子（男性，p = 0.004；女性，p = 0.047）。结论本研究结果表明，与男性相比，女性可采用不同的脂蛋白（a）水平阈值进行风险分层。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.