{"title":"Association of lipoprotein(a) and coronary artery calcium with atherosclerotic cardiovascular disease.","authors":"Byung Jin Kim, Jeonggyu Kang","doi":"10.1016/j.jacl.2025.02.007","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A combined evaluation of the associations of lipoprotein(a) (LP[a]) and coronary artery calcium score (CACS) with atherosclerotic cardiovascular disease (ASCVD) has not been conducted in the Asian population.</p><p><strong>Objective: </strong>We explored whether elevated LP(a) levels and CACS are independently and jointly associated with ASCVD.</p><p><strong>Methods: </strong>This cross-sectional study included 44,354 participants (mean age 40.6 years, 72.8% male) from the Kangbuk Samsung Health Study, conducted between March 2010 and December 2019, who were tested for LP(a) and CACS. High LP(a) was defined as LP(a) ≥120 nmol/L, and CACS categories were divided as CACS = 0 vs CACS > 0. ASCVD was identified as physician-diagnosed or -treated angina pectoris, myocardial infarction, or ischemic stroke.</p><p><strong>Results: </strong>The prevalence of high LP(a), CACS >0, and ASCVD was 11.9%, 15.7%, and 1.1%, respectively. Multivariable regression analyses indicated that high LP(a) and CACS >0 were independently associated with prevalent ASCVD (odds ratio [95% CI], 1.36 [1.02, 1.81] and 1.79 [1.40, 2.30], respectively). Compared with individuals with low LP(a)/CACS = 0, those with high LP(a)/CACS > 0 had the highest OR for ASCVD (2.40 [1.58, 3.63]), as did those with low LP(a)/CACS > 0 (1.79 [1.38, 2.33]). However, high LP(a)/CACS = 0 did not significantly increase the OR for ASCVD (1.36 [0.90, 2.05]).</p><p><strong>Conclusion: </strong>High LP(a) levels and the presence of CAC are independently associated with ASCVD. Given that both markers were additively associated with ASCVD when elevated, more aggressive management to reduce cardiovascular risk may be warranted. Longitudinal studies are necessary to clarify the combined causal relationship between these 2 markers and cardiovascular events in the Asian population.</p>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of clinical lipidology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jacl.2025.02.007","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: A combined evaluation of the associations of lipoprotein(a) (LP[a]) and coronary artery calcium score (CACS) with atherosclerotic cardiovascular disease (ASCVD) has not been conducted in the Asian population.
Objective: We explored whether elevated LP(a) levels and CACS are independently and jointly associated with ASCVD.
Methods: This cross-sectional study included 44,354 participants (mean age 40.6 years, 72.8% male) from the Kangbuk Samsung Health Study, conducted between March 2010 and December 2019, who were tested for LP(a) and CACS. High LP(a) was defined as LP(a) ≥120 nmol/L, and CACS categories were divided as CACS = 0 vs CACS > 0. ASCVD was identified as physician-diagnosed or -treated angina pectoris, myocardial infarction, or ischemic stroke.
Results: The prevalence of high LP(a), CACS >0, and ASCVD was 11.9%, 15.7%, and 1.1%, respectively. Multivariable regression analyses indicated that high LP(a) and CACS >0 were independently associated with prevalent ASCVD (odds ratio [95% CI], 1.36 [1.02, 1.81] and 1.79 [1.40, 2.30], respectively). Compared with individuals with low LP(a)/CACS = 0, those with high LP(a)/CACS > 0 had the highest OR for ASCVD (2.40 [1.58, 3.63]), as did those with low LP(a)/CACS > 0 (1.79 [1.38, 2.33]). However, high LP(a)/CACS = 0 did not significantly increase the OR for ASCVD (1.36 [0.90, 2.05]).
Conclusion: High LP(a) levels and the presence of CAC are independently associated with ASCVD. Given that both markers were additively associated with ASCVD when elevated, more aggressive management to reduce cardiovascular risk may be warranted. Longitudinal studies are necessary to clarify the combined causal relationship between these 2 markers and cardiovascular events in the Asian population.
期刊介绍：
Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner.
Sections of Journal of clinical lipidology will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.
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