Lipoprotein(a) and prothrombotic effects: Evidence from a genetic association study

IF 5.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Internal Medicine Pub Date : 2025-05-01 DOI:10.1016/j.ejim.2025.01.021

Elena Olmastroni , Julius L. Katzmann , Federica Galimberti , Ulrich Laufs , Alberico L. Catapano

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引用次数: 0

Abstract

Background

It is unknown whether lipoprotein(a) [Lp(a)] has prothrombotic effects contributing to its association with the risk of myocardial infarction (MI).

Methods

In 410,177 participants of UK Biobank, associations of LPA genetic variants and observed Lp(a) concentrations with the risk of venous thromboembolism (VTE) and MI were investigated, stratified by scores of genetic variants influencing coagulation through the thrombin and platelet pathways (denoted as F2/F5 and GUCY1A3 scores, respectively). Risk estimates are expressed as hazard ratio (HR) and 95% confidence interval (95% CI).

Results

Neither LPA genetic variants nor observed Lp(a) concentration were associated with the risk of incident VTE (HR per 100 nmol/L higher Lp(a) 1.02, 95% CI 1.00–1.04, p=0.13). In contrast, there was a strong association with the risk of incident MI (HR per 100 nmol/L higher Lp(a) 1.31, 95% CI 1.29–1.33, p<0.001). The F2/F5 score was associated with a stepwise decrease in the risk of VTE, and the GUCY1A3 score with a stepwise decrease in the risk of MI. However, the associations of LPA genetic variants and observed Lp(a) concentrations with the risk of MI were not modified by stratification for either of the coagulation scores.

Conclusion

The association between Lp(a) and MI was not modified by genetically determined levels of coagulation activity through the thrombin or platelet pathway. Our findings do not support the notion that the increased risk of MI caused by elevated Lp(a) is due to prothrombotic effects.

Abstract Image

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脂蛋白（a）和促血栓形成作用：遗传关联研究的证据：脂蛋白（a）的促血栓形成作用。

背景：目前尚不清楚脂蛋白(a) [Lp(a)]是否具有促血栓作用，导致其与心肌梗死（MI）风险相关。方法：在英国生物银行的410,177名参与者中，研究了LPA遗传变异和观察到的Lp(a)浓度与静脉血栓栓塞（VTE）和心肌梗死风险的关系，并通过通过凝血酶和血小板途径影响凝血的遗传变异评分（分别表示为F2/F5和GUCY1A3评分）进行分层。风险估计用风险比（HR）和95%置信区间（95% CI）表示。结果：LPA遗传变异和观察到的Lp(a)浓度均与VTE发生的风险无关（Lp(a)每100 nmol/L高的HR为1.02,95% CI为1.00-1.04,p=0.13）。相反，Lp(a)与心肌梗死发生风险有很强的相关性（每100 nmol/L高的Lp(a)的HR为1.31,95% CI为1.29-1.33,p）。结论：Lp(a)与心肌梗死之间的相关性不受通过凝血酶或血小板途径决定的凝血活性水平的遗传影响。我们的研究结果不支持由Lp(a)升高引起的心肌梗死风险增加是由于血栓前作用的观点。

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

European Journal of Internal Medicine 医学-医学：内科

CiteScore

9.60

自引率

6.20%

发文量

364

审稿时长

20 days

期刊介绍： The European Journal of Internal Medicine serves as the official journal of the European Federation of Internal Medicine and is the primary scientific reference for European academic and non-academic internists. It is dedicated to advancing science and practice in internal medicine across Europe. The journal publishes original articles, editorials, reviews, internal medicine flashcards, and other relevant information in the field. Both translational medicine and clinical studies are emphasized. EJIM aspires to be a leading platform for excellent clinical studies, with a focus on enhancing the quality of healthcare in European hospitals.