Association between lipoprotein (a) levels and cardiac allograft vasculopathy among heart transplant recipients: Insights from a single-center cohort

IF 6.9 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology Pub Date : 2026-09-01 Epub Date: 2026-07-20 DOI:10.1016/j.jacl.2026.07.024

Daniela Bacich MD, Enrico Giuseppe Italiano MD, Marika Faggioli MD, Laura Rizzo MD, Nicola Pradegan MD, Giuseppe Toscano MD, Chiara Tessari MD, PhD, Vincenzo Tarzia MD, PhD

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Abstract

BACKGROUND

Serum lipoprotein (a) [Lp(a)] is a causal risk factor for atherosclerotic cardiovascular disease in the general population, but its association with cardiac allograft vasculopathy (CAV) development has not been firmly established.

OBJECTIVE

To assess the distribution of Lp(a) levels in heart transplant (HT) recipients and evaluate the correlation between Lp(a) levels and the presence and severity of CAV.

METHODS

A retrospective observational cohort study encompassing 271 adult HT recipients on regular outpatient follow-up in a tertiary center. Lp(a) concentration was assessed during the last follow-up visit and compared between patients with and without clinically significant CAV, International Society for Heart and Lung Transplantation (grade 2-3 vs 0-1).

RESULTS

Median serum Lp(a) concentration was 40 nmol/L; 62 patients (23%) had Lp(a) >125 nmol/L. Median Lp(a) levels did not significantly differ between patients with CAV 0-1 and patients with CAV 2-3 (median 37 vs 55 nmol/L, P = 0.408). High (>125 nmol/L) Lp(a) levels were not associated with CAV 2-3, neither on univariable nor on multivariable analysis (hazard ratio multivariate 1.02, 95% CI: 0.35-2.95, P = 0.977). Elevated Lp(a) concentrations (>75, >125, >200 nmol/L) did not show significant correlation with either CAV 2-3 nor with CAV 1-2-3. Older donor age was significantly related to CAV development (+1.018% increase of CAV for every year of increase of donor age, P value 0.009).

CONCLUSION

Elevated serum Lp(a) levels were not associated with the presence and severity of CAV in patients with HT with long post-transplant follow-up. The relationship between Lp(a) and CAV warrants further investigation, given the small sample of the current study.

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心脏移植受者中脂蛋白(a)水平与心脏移植血管病变之间的关系：来自单中心队列的见解

背景：血清脂蛋白(a) [Lp(a)]是普通人群中动脉粥样硬化性心血管疾病的一个因果危险因素，但其与心脏异体移植血管病变（CAV）发展的关系尚未得到明确证实。目的：探讨心脏移植（HT）受者血浆Lp(a)水平的分布，并探讨Lp(a)水平与CAV存在及严重程度的相关性。方法：一项回顾性观察队列研究，包括271名成人HT接受者在三级中心定期门诊随访。在最后一次随访期间评估Lp(a)浓度，并比较有无临床显著CAV的患者，国际心肺移植学会（分级2-3 vs 0-1）。结果：血清Lp(a)中位浓度为40 nmol/L；62例（23%）患者Lp(a) >125 nmol/L。中位Lp(a)水平在CAV 0-1患者和CAV 2-3患者之间无显著差异（中位37 vs 55 nmol/L， P = .408）。无论是单变量分析还是多变量分析，高（125 nmol/L） Lp(a)水平均与CAV - 2-3无关（多变量风险比1.02,95% CI: 0.35-2.95, P = 0.977）。升高的Lp(a)浓度（bbb75、>25、>00 nmol/L）与CAV 2-3和CAV 1-2-3均无显著相关性。供体年龄越大，CAV的发生与供体年龄越相关（供体年龄每增加1年，CAV增加1.018%，P值为0.009）。结论：移植后长期随访的HT患者血清Lp(a)水平升高与CAV的存在和严重程度无关。考虑到当前研究的小样本，Lp(a)和CAV之间的关系值得进一步调查。

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

Journal of clinical lipidology 医学-药学

CiteScore

7.00

自引率

6.80%

发文量

209

审稿时长

49 days

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.