{"title":"泰国脂蛋白(a)水平与动脉粥样硬化性心血管疾病的关系：一项横断面研究","authors":"Lukana Preechasuk, Tanawan Kongmalai, Varisara Lapinee, Busadee Pratumvinit, Nuntakorn Thongtang","doi":"10.2147/VHRM.S544693","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The optimal plasma lipoprotein(a) [Lp(a)] cutoff level for predicting atherosclerotic cardiovascular disease (ASCVD) in Southeast Asian populations remains limited. Therefore, our study aimed to identify the optimal plasma Lp(a) cutoff for predicting ASCVD in Thai patients.</p><p><strong>Patients and methods: </strong>We conducted a retrospective analysis of patients who underwent Lp(a) measurement at Siriraj Hospital between January 2019 and August 2024. Inclusion criteria included Thai ethnicity and age ≥15 years. Baseline characteristics, comorbidities, laboratory data, and Lp(a) levels were extracted from medical records. Lp(a) levels were compared between ASCVD and non-ASCVD groups. Odds ratios (OR) for ASCVD and coronary artery disease (CAD) were calculated using Lp(a)<25 nmol/L as the reference.</p><p><strong>Results: </strong>A total of 2341 patients (age 54.4±17.7 years, 42.0% male) were included. Among them, 413 (17.6%) had ASCVD, 254 (10.9%) had CAD, 186 (7.9%) had ischemic stroke, 21 (0.9%) had peripheral arterial disease (PAD), and 14 (0.6%) had abdominal aortic aneurysm. Median Lp(a) levels (nmol/L) were significantly higher in patients with ASCVD [37.2 vs 24.4, p<0.001], CAD [43.8 vs 24.5, p<0.001], and AS [51.6 vs 25.3, p=0.002] compared to those without diseases. After adjusting for other risk factors, Lp(a)≥40 nmol/L was associated with increased risks of ASCVD [OR 1.538 (1.203-1.958)] and CAD [OR 1.877 (1.407-2.505)]. A multivariate model incorporating Lp(a)≥40 nmol/L with other risk factors demonstrated 70-80% sensitivity and specificity for predicting ASCVD and CAD.</p><p><strong>Conclusion: </strong>Elevated plasma Lp(a) levels are significantly associated with ASCVD and CAD. An Lp(a) cutoff of≥40 nmol/L predicted ASCVD and CAD risk in Thai.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"21 ","pages":"813-822"},"PeriodicalIF":2.8000,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474652/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Association of Lipoprotein(a) Levels with Atherosclerotic Cardiovascular Disease in Thailand: A Cross-Sectional Study.\",\"authors\":\"Lukana Preechasuk, Tanawan Kongmalai, Varisara Lapinee, Busadee Pratumvinit, Nuntakorn Thongtang\",\"doi\":\"10.2147/VHRM.S544693\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The optimal plasma lipoprotein(a) [Lp(a)] cutoff level for predicting atherosclerotic cardiovascular disease (ASCVD) in Southeast Asian populations remains limited. Therefore, our study aimed to identify the optimal plasma Lp(a) cutoff for predicting ASCVD in Thai patients.</p><p><strong>Patients and methods: </strong>We conducted a retrospective analysis of patients who underwent Lp(a) measurement at Siriraj Hospital between January 2019 and August 2024. Inclusion criteria included Thai ethnicity and age ≥15 years. Baseline characteristics, comorbidities, laboratory data, and Lp(a) levels were extracted from medical records. Lp(a) levels were compared between ASCVD and non-ASCVD groups. Odds ratios (OR) for ASCVD and coronary artery disease (CAD) were calculated using Lp(a)<25 nmol/L as the reference.</p><p><strong>Results: </strong>A total of 2341 patients (age 54.4±17.7 years, 42.0% male) were included. Among them, 413 (17.6%) had ASCVD, 254 (10.9%) had CAD, 186 (7.9%) had ischemic stroke, 21 (0.9%) had peripheral arterial disease (PAD), and 14 (0.6%) had abdominal aortic aneurysm. Median Lp(a) levels (nmol/L) were significantly higher in patients with ASCVD [37.2 vs 24.4, p<0.001], CAD [43.8 vs 24.5, p<0.001], and AS [51.6 vs 25.3, p=0.002] compared to those without diseases. After adjusting for other risk factors, Lp(a)≥40 nmol/L was associated with increased risks of ASCVD [OR 1.538 (1.203-1.958)] and CAD [OR 1.877 (1.407-2.505)]. A multivariate model incorporating Lp(a)≥40 nmol/L with other risk factors demonstrated 70-80% sensitivity and specificity for predicting ASCVD and CAD.</p><p><strong>Conclusion: </strong>Elevated plasma Lp(a) levels are significantly associated with ASCVD and CAD. An Lp(a) cutoff of≥40 nmol/L predicted ASCVD and CAD risk in Thai.</p>\",\"PeriodicalId\":23597,\"journal\":{\"name\":\"Vascular Health and Risk Management\",\"volume\":\"21 \",\"pages\":\"813-822\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-09-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474652/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Vascular Health and Risk Management\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/VHRM.S544693\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vascular Health and Risk Management","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/VHRM.S544693","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
摘要
目的：预测东南亚人群动脉粥样硬化性心血管疾病（ASCVD）的最佳血浆脂蛋白(a) [Lp(a)]截止水平仍然有限。因此，我们的研究旨在确定预测泰国患者ASCVD的最佳血浆Lp(a)截止值。患者和方法：我们对2019年1月至2024年8月期间在Siriraj医院接受Lp(a)测量的患者进行了回顾性分析。纳入标准为泰国民族和年龄≥15岁。从医疗记录中提取基线特征、合并症、实验室数据和Lp(a)水平。比较ASCVD组和非ASCVD组的Lp(a)水平。使用Lp(a)计算ASCVD和冠心病（CAD）的比值比（OR）。结果：共纳入2341例患者（年龄54.4±17.7岁，男性42.0%）。其中ASCVD 413例（17.6%），CAD 254例（10.9%），缺血性脑卒中186例（7.9%），外周动脉疾病（PAD） 21例（0.9%），腹主动脉瘤14例（0.6%）。ASCVD患者的中位Lp(a)水平（nmol/L）显著高于ASCVD患者[37.2 vs 24.4, p]。结论：血浆Lp(a)水平升高与ASCVD和CAD显著相关。在泰国，Lp(a)临界值≥40 nmol/L可预测ASCVD和CAD风险。
The Association of Lipoprotein(a) Levels with Atherosclerotic Cardiovascular Disease in Thailand: A Cross-Sectional Study.
Purpose: The optimal plasma lipoprotein(a) [Lp(a)] cutoff level for predicting atherosclerotic cardiovascular disease (ASCVD) in Southeast Asian populations remains limited. Therefore, our study aimed to identify the optimal plasma Lp(a) cutoff for predicting ASCVD in Thai patients.
Patients and methods: We conducted a retrospective analysis of patients who underwent Lp(a) measurement at Siriraj Hospital between January 2019 and August 2024. Inclusion criteria included Thai ethnicity and age ≥15 years. Baseline characteristics, comorbidities, laboratory data, and Lp(a) levels were extracted from medical records. Lp(a) levels were compared between ASCVD and non-ASCVD groups. Odds ratios (OR) for ASCVD and coronary artery disease (CAD) were calculated using Lp(a)<25 nmol/L as the reference.
Results: A total of 2341 patients (age 54.4±17.7 years, 42.0% male) were included. Among them, 413 (17.6%) had ASCVD, 254 (10.9%) had CAD, 186 (7.9%) had ischemic stroke, 21 (0.9%) had peripheral arterial disease (PAD), and 14 (0.6%) had abdominal aortic aneurysm. Median Lp(a) levels (nmol/L) were significantly higher in patients with ASCVD [37.2 vs 24.4, p<0.001], CAD [43.8 vs 24.5, p<0.001], and AS [51.6 vs 25.3, p=0.002] compared to those without diseases. After adjusting for other risk factors, Lp(a)≥40 nmol/L was associated with increased risks of ASCVD [OR 1.538 (1.203-1.958)] and CAD [OR 1.877 (1.407-2.505)]. A multivariate model incorporating Lp(a)≥40 nmol/L with other risk factors demonstrated 70-80% sensitivity and specificity for predicting ASCVD and CAD.
Conclusion: Elevated plasma Lp(a) levels are significantly associated with ASCVD and CAD. An Lp(a) cutoff of≥40 nmol/L predicted ASCVD and CAD risk in Thai.
期刊介绍：
An international, peer-reviewed journal of therapeutics and risk management, focusing on concise rapid reporting of clinical studies on the processes involved in the maintenance of vascular health; the monitoring, prevention, and treatment of vascular disease and its sequelae; and the involvement of metabolic disorders, particularly diabetes. In addition, the journal will also seek to define drug usage in terms of ultimate uptake and acceptance by the patient and healthcare professional.
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