Lipoprotein (a) and Venous Thromboembolism in Adults: A Meta-Analysis

Abstract

BACKGROUND: Lipoprotein (a) [Lp(a)], a low-density lipoprotein particle linked to apolipoprotein (a), has been recently demonstrated to be an independent risk factor for arterial vascular diseases. However, despite increasing evidence of the association between high Lp(a) and arterial thrombotic diseases, few and conflicting results on the association between high Lp(a) levels and venous thromboembolism have been obtained. The aim of this article is to systematically examine the published data on the association between high Lp(a) levels and venous thromboembolism. METHODS: A systematic search of all publications listed in the electronic databases (Medline, EMBASE, Web of Science, and The Cochrane Library) up to November 2006, using keywords in combination both as MeSH terms and text words, was conducted. RESULTS: Six case-control studies were included, incorporating 1826 cases of venous thromboembolism and 1074 controls. The summary odds ratios of included case-control studies under a fixed-effects model showed a statistically significant association between Lp(a) levels Ͼ300 mg/L and venous thromboembolism: 1.87, 95% confidence interval (CI), 1.51-2.30; P Ͻ.0001. Furthermore, a random-effects model, which accounts for the interstudy variation, yielded a similar estimate of increased risk (odds ratio [OR] 1.77; 95% CI, 1.14-2.75; P ϭ .01). CONCLUSIONS:The present meta-analysis shows a significant association between high Lp(a) levels and the occurrence of venous thromboembolism in adults. Indeed, the detection of Lp(a) could be of clinical relevance for venous thromboembolism, especially among patients with absence of traditional and thrombophilic risk factors.

High lipoprotein (a) levels are associated with an increased risk of retinal vein occlusion

“…Due to its structural homologies with plasminogen and cholesterol molecules, Lp(a) has been found to be implicated in the inhibition of fibrinolysis as well as in atherogenesis. Currently, epidemiological evidence has reported a pathogenetic role for high levels of Lp(a) in the occurrence of both arterial and venous thrombotic diseases [24,25] whereas few and conflicting results have been obtained relating to the occurrence of RVO [10][11][12][13][14][15][16].…”

Lipoprotein (a) as a cause of cardiovascular disease: insights from epidemiology, genetics, and biology

“…A meta-analysis from 2007, including six case-control studies with 1,826 patients with venous thromboembolism and 1,074 controls, found an odds ratio for venous thromboembolism of 1.8 (95% CI: 1.1-2.8) for Lp(a) concentrations above versus below 30 mg/dl (224). Three of the studies in the meta-analysis found individually higher risk of venous thromboembolism (225)(226)(227), whereas three studies had insignificant results (228)(229)(230).…”

Endothelium, venous thromboembolism and ischaemic cardiovascular events

“…Furthermore, the increased incidence of VTE in patients with risk factors for arterial cardiovascular events points too to a common pathogenesis (6). Indeed, a number of studies, with different design and in various clinical settings, have shown an increased risk of VTE associated with most of the classic or novel risk factor for ischaemic cardiovascular disease (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) (ǠTable 1).…”