Association Between Lipoprotein (a) and Risk of Atrial Fibrillation: A Systematic Review and Meta-analysis of Mendelian Randomization Studies

Singh, Sandeep; Baars, Daniël P; Desai, Rupak; Singh, Dyutima; Pinto-Sietsma, Sara-Joan

doi:10.1016/j.cpcardiol.2023.102024

Cited by 8 publications

(7 citation statements)

References 48 publications

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“…A meta-analysis including 275,647 AF cases and 2.1 million patients with Lp(a) showed that increased Lp(a) was associated with a very small increased risk of AF in studies based on Mendelian randomisation (OR = 1.024, 95% CI: 1.007–1.042, p < 0.001). The authors found a higher risk of AF in the European cohort (OR = 1.023, 95% CI: 1.007–1.040, p < 0.001) and a low risk (OR = 0.940, 95% CI: 0.893–0.990) in the Chinese population [ 4 ]. On the other hand, Garg et al .…”

Section: Lipoprotein(a) and Cardiovascular Diseasementioning

confidence: 99%

“…Lp(a) is also associated with peripheral artery disease (PAD) and, to a lesser extent, with ischaemic stroke (IS) and heart failure (HF) [3]. Recent studies also suggest that higher levels of Lp(a) may be associated with an increased risk of atrial fibrillation (AF), but this requires further confirmation in studies [4][5][6]. In contrast, the association between Lp(a) and the risk of venous thromboembolism is not supported by most recent studies [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Non-genetic factors and their influence on Lp(a) concentrations. Modified based on[100] completed with the information from: 1 [101]; 2[102];3 [103];4 [104] …”

mentioning

confidence: 99%

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Recommendations of the Experts of the Polish Cardiac Society (PCS) and the Polish Lipid Association (PoLA) on the diagnosis and management of elevated lipoprotein(a) levels

Sosnowska,

Stepinska,

Mitkowski

et al. 2024

Arch Med Sci

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Elevated Lp(a) levels ≥50 mg/dl are estimated to occur in more than 1.5 billion people worldwide. However, determination of Lp(a) levels is performed far too rarely, including Poland, where, in fact, it is only since the 2021 PoLA guidelines that Lp(a) measurements have begun to be performed. Determination of Lp(a) concentrations is not easy due to, among other things, the different sizes of the apo(a) isoforms; however, the currently available certified tests make it possible to distinguish between people with low and high cardiovascular risk with a high degree of precision. In 2022, the first guidelines for the management of patients with elevated Lp(a) levels were published by the EAS and the AHA. The first Polish guidelines are the result of the work of experts from the two scientific societies and their aim is to provide clear, practical recommendations for the determination and management of elevated Lp(a) levels.

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Section: Lipoprotein(a) and Cardiovascular Diseasementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Recommendations of the Experts of the Polish Cardiac Society (PCS) and the Polish Lipid Association (PoLA) on the diagnosis and management of elevated lipoprotein(a) levels

Sosnowska,

Stepinska,

Mitkowski

et al. 2024

Arch Med Sci

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show abstract

“…Mendelian studies also associate a high Lp(a) with a mildly though significantly higher risk of developing atrial fibrillation. The pathophysiological link between these two conditions, however, has yet to be clarified [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Apolipoprotein(a) Isoform Size Using Phenotypic and Genotypic Methods

Fogacci,

Di Micoli,

Avagimyan

et al. 2023

IJMS

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Apolipoprotein(a) (apo(a)) is the protein component that defines lipoprotein(a) (Lp(a)) particles and is encoded by the LPA gene. The apo(a) is extremely heterogeneous in size due to the copy number variations in the kringle-IV type 2 (KIV2) domains. In this review, we aim to discuss the role of genetics in establishing Lp(a) as a risk factor for coronary heart disease (CHD) by examining a series of molecular biology techniques aimed at identifying the best strategy for a possible application in clinical research and practice, according to the current gold standard.

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“…The length of apo(a) and the plasma levels of Lp(a) are strictly genetically determined [1]. In recent decades, several epidemiological studies have definitively shown that high Lp(a) levels are associated with a significant increase not only in the risk of atherosclerosisrelated cardiovascular (ASCV) events (namely coronary artery disease (CAD), stroke and peripheral artery disease) [2] but also aortic stenosis [3] and atrial fibrillation [4].…”

Section: Introductionmentioning

confidence: 99%

Estimating the Prevalence and Characteristics of Patients Potentially Eligible for Lipoprotein(a)-Lowering Therapies in a Real-World Setting

Cicero,

Fogacci,

Giovannini

et al. 2023

Biomedicines

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High lipoprotein(a) (Lp(a)) plasma levels are significantly associated with an increased risk of developing atherosclerotic cardiovascular diseases (ASCVD). The aim of this analysis was to estimate the prevalence and characteristics of patients potentially eligible for Lp(a)-lowering therapies in a real-world setting (i.e., patients with ASCVD and Lp(a) levels > 70 mg/dL). For this reason, we pooled data from a large cohort of Italian outpatients (N = 5961; men: 2879, women: 3982) with dyslipidemia. A binary logistic regression analysis was used to determine the significant predictors of ASCVD in the cohort, which were age (Odds Ratio (OR): 1.158, 95% Confidence Interval (CI): 1.114 to 1.203, p < 0.001), low-density lipoprotein cholesterol at entry (OR: 1.989, 95% CI: 1.080 to 1.198, p = 0.020) and Lp(a) (OR: 1.090, 95% CI: 1.074 to 1.107, p < 0.001). In our cohort, almost half of patients with ASCVD (44.7%) may be eligible to be treated with Lp(a)-lowering agents. Interestingly, patients who do not meet the treatment criteria despite high Lp(a) (50–70 mg/dL), respectively, account for 4.7% and 7.3% of those in primary and secondary ASCVD prevention. In conclusion, in our large cohort of outpatients with dyslipidemia, the prevalence of individuals with ASCVD and very high Lp(a) plasma levels is quite high, even with a conservative estimation.

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Association Between Lipoprotein (a) and Risk of Atrial Fibrillation: A Systematic Review and Meta-analysis of Mendelian Randomization Studies

Cited by 8 publications

References 48 publications

Recommendations of the Experts of the Polish Cardiac Society (PCS) and the Polish Lipid Association (PoLA) on the diagnosis and management of elevated lipoprotein(a) levels

Recommendations of the Experts of the Polish Cardiac Society (PCS) and the Polish Lipid Association (PoLA) on the diagnosis and management of elevated lipoprotein(a) levels

Assessment of Apolipoprotein(a) Isoform Size Using Phenotypic and Genotypic Methods

Estimating the Prevalence and Characteristics of Patients Potentially Eligible for Lipoprotein(a)-Lowering Therapies in a Real-World Setting

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