Phenomapping of subgroups in high-Lp(a) patients: a data-driven cluster analysis in RED-CARPET study.

IF 3.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Research in Cardiology Pub Date : 2025-06-23 DOI:10.1007/s00392-025-02669-6

Shaozhao Zhang, Xiaoyu Lin, Rongjian Zhan, Huimin Zhou, Yuhui Lai, Mengting Huang, Bingzhen Li, Xinxue Liao, Xiaodong Zhuang

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引用次数: 0

Abstract

Background: The association between high levels of lipoprotein (a) [Lp(a)] and cardiovascular disease (CVD) is influenced by clinical characteristics. We aimed to explore the heterogeneity in high Lp(a) population with different clinical phenotypes and their relationship with atherosclerosis cardiovascular disease (ASCVD) risk.

Methods and results: We included 11,629 participants with Lp(a) measurement in RED-CARPET Study (ChiCTR2000039901) from the First Affiliated Hospital of Sun Yat-Sen University. The primary outcome was the occurrence of ASCVD events. The k-means clustering method was performed for baseline variables in participants with high Lp(a) levels (Lp(a) ≥ 50 mg/dL). Multivariate logistic regression model was used to assess the association between high Lp(a) level and ASCVD across clusters, with the low-Lp(a) group (Lp(a) < 50 mg/dL) serving as reference. Propensity score matching (PSM) was used to validate thefindings. High-Lp(a) group was categorized into four clusters: cluster 1 (dyslipidemia); cluster 2 (aged females); cluster 3 (males with an unhealthy lifestyle) and cluster 4 (anemia, renal insufficiency and hypercoagulability). Patients in different clusters exhibited differences in ASCVD risk. Patients with high-Lp(a) had significantly highest risk for ASCVD in cluster 3 (OR 2.12, 95% CI 1.62-2.76, p < 0.001) after adjusting for traditional risk factors. However, no significant association was observed in cluster 4 (OR 0.82, 95% CI 0.58-1.16, p = 0.233). These findings remained consistent after PSM.

Conclusions: Using a data-driven approach, high-Lp(a) patients can be stratified into four phenotypically distinct subgroups with different ASCVD risk.

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高lp (a)患者亚组的现象映射：RED-CARPET研究的数据驱动聚类分析

背景：高水平脂蛋白(a) [Lp(a)]与心血管疾病（CVD）之间的关系受到临床特征的影响。我们旨在探讨具有不同临床表型的高脂蛋白(a)人群的异质性及其与动脉粥样硬化心血管疾病（ASCVD）风险的关系。方法与结果：我们纳入了中山大学第一附属医院红地毯研究（ChiCTR2000039901）中Lp(a)测量的11,629名受试者。主要终点是ASCVD事件的发生。对高Lp(a)水平（Lp(a)≥50 mg/dL）参与者的基线变量采用k-均值聚类方法。使用多变量logistic回归模型评估高脂蛋白(a)水平与跨集群的ASCVD之间的关系，低脂蛋白(a)组（Lp(a)）结论：使用数据驱动的方法，高脂蛋白(a)患者可以分为四个表型不同的亚组，不同的ASCVD风险。

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 Research in Cardiology 医学-心血管系统

CiteScore

11.40

自引率

4.00%

发文量

140

审稿时长

4-8 weeks

期刊介绍： Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery. As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.