Real life validation of the European Atherosclerosis Society Consensus Panel lipoprotein(a) threshold of 50mg/dL

Seguro, Florent; Bérard, Emilie; Bongard, Vanina; Ruidavets, J.B.; Galinier, Michel; Carrié, Didier; Ferrières, Jean

doi:10.1016/j.ijcard.2016.07.018

Cited by 4 publications

(7 citation statements)

References 9 publications

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“…On the other hand, the main objective of the present study was to evaluate a possible association between Lp( a ) concentrations and platelet reactivity in response to ADP. The ADP-P2Y 12 pathway has stronger a association with ischemic events or mortality [ 22 ] and could be involved in the potential prothrombotic risk of Lp( a ) for individuals in primary and secondary prevention [ 8 , 23 – 26 , 34 ]. Second, we did not assess the effect of apo( a ) on platelet reactivity, which appears to have an additional effect on aggregation [ 17 , 18 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our main finding was that high Lp(a) concentration, defined as Lp(a) C 50 mg/dL [23][24][25][26]34], is unrelated to platelet reactivity as assessed by multiple established tests [31][32][33][34][35][36], and regardless of the presence or absence of CAD. To the best of our knowledge, the present study is the first to analyze the potential association between high concentrations of Lp(a) and platelet reactivity in individuals with and without CAD, which could contribute to a better understanding of the pathophysiology of atherosclerosis [2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

“…Individuals were categorized into two groups according to Lp( a ) concentrations above or below 50 mg/dL. This cutoff was based on the current recommendations of the European Atherosclerosis Society [ 7 , 23 ], American College of Cardiology/American Heart Association (ACC/AHA) [ 24 , 25 ], and National Lipid Association [ 26 ]. Additionally, we used Lp( a ) quartiles and Lp( a ) with a threshold of 70 mg/dL to further evaluate the primary endpoint of this study.…”

Section: Methodsmentioning

confidence: 99%

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Relation of High Lipoprotein (a) Concentrations to Platelet Reactivity in Individuals with and Without Coronary Artery Disease

et al. 2020

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Introduction Lipoprotein ( a ) [Lp( a )] is a risk factor for coronary artery disease (CAD). To the best of our knowledge, this is the first study addressing the relationship between Lp( a ) and platelet reactivity in primary and secondary prevention. Methods Lp( a ) was evaluated in 396 individuals with (82.3%) and without (17.7%) obstructive CAD. The population was divided into two groups according to Lp( a ) concentrations with a cutoff value of 50 mg/dL. The primary objective was to evaluate the association between Lp( a ) and adenosine diphosphate (ADP)-induced platelet reactivity using the VerifyNow™ P2Y 12 assay. Platelet reactivity was also induced by arachidonic acid and collagen–epinephrine (C-EPI) and assessed by Multiplate™, platelet function analyzer™ 100 (PFA-100), and light transmission aggregometry (LTA) assays. Secondary objectives included the assessment of the primary endpoint in individuals with or without CAD. Results Overall, 294 (74.2%) individuals had Lp( a ) < 50 mg/dL [median (IQR) 13.2 (5.8–27.9) mg/dL] and 102 (25.8%) had Lp( a ) ≥ 50 mg/dL [82.5 (67.6–114.5) mg/dL], P < 0.001. Univariate analysis in the entire population revealed no differences in ADP-induced platelet reactivity between individuals with Lp( a ) ≥ 50 mg/dL (249.4 ± 43.8 PRU) versus Lp( a ) < 50 mg/dL (243.1 ± 52.2 PRU), P = 0.277. Similar findings were present in individuals with ( P = 0.228) and without ( P = 0.669) CAD, and regardless of the agonist used or method of analysis (all P > 0.05). Finally, multivariable analysis did not show a significant association between ADP-induced platelet reactivity and Lp( a ) ≥ 50 mg/dL [adjusted OR = 1.00 [(95% CI 0.99–1.01), P = 0.590]. Conclusion In individuals with or without CAD, Lp( a ) ≥ 50 mg/dL was not associated with higher platelet reactivity. Electronic supplementary material The online version of this article (10.1007/s12325-020-01483-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Relation of High Lipoprotein (a) Concentrations to Platelet Reactivity in Individuals with and Without Coronary Artery Disease

et al. 2020

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“…No significant association was found in patients with CRF or DM. The results of meta-analysis were not robust in leave-one-out analysis in general population by removing several effect sizes [11,12,34,62,63,[65][66][67], but in patients with CVD, the association remained unchanged (Supplementary Figure -6-A and B). Funnel plots showed no asymmetry in both populations (Egger's p-value > 0.05, Supplementary Figure -7-A and B).…”

Section: All-cause Mortalitymentioning

confidence: 92%

“…Briefly, these studies have been published between 1998 and 2020. The association of Lp(a) concentration and all-cause or cause-specific mortality was reported in general or healthy populations [8,11,12,34,36,[58][59][60][61][62][63][64][65][66][67][68][69][70], individuals with CVD [13,14,30,67,69,[71][72][73][74][75][76][77][78][79][80][81][82][83][84], chronic renal failure (CRF) [27,[31][32][33], and DM [10,15,67,85,86]. One study was conducted in women only [78] and two in men only [64,68].…”

Section: Risk Conversionsmentioning

confidence: 99%

Circulating lipoprotein (a) and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis

et al. 2023

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Aims To investigate the association between circulating lipoprotein(a) (Lp(a)) and risk of all-cause and cause-specific mortality in the general population and in patients with chronic diseases, and to elucidate the dose-response relations. Methods and results We searched literature to find prospective studies reporting adjusted risk estimates on the association of Lp(a) and mortality outcomes. Forty-three publications, reporting on 75 studies (957,253 participants), were included. The hazard ratios (HRs) and 95% confidence intervals (95%CI ) for the top versus bottom tertile of Lp(a) levels and risk of all-cause mortality were 1.09 (95%CI: 1.01–1.18, I2: 75.34%, n = 19) in the general population and 1.18 (95%CI: 1.04–1.34, I2: 52.5%, n = 12) in patients with cardiovascular diseases (CVD). The HRs for CVD mortality were 1.33 (95%CI: 1.11–1.58, I2: 82.8%, n = 31) in the general population, 1.25 (95%CI: 1.10–1.43, I2: 54.3%, n = 17) in patients with CVD and 2.53 (95%CI: 1.13–5.64, I2: 66%, n = 4) in patients with diabetes mellitus. Linear dose-response analyses revealed that each 50 mg/dL increase in Lp(a) levels was associated with 31% and 15% greater risk of CVD death in the general population and in patients with CVD. No non-linear dose-response association was observed between Lp(a) levels and risk of all-cause or CVD mortality in the general population or in patients with CVD (Pnonlinearity > 0.05). Conclusion This study provides further evidence that higher Lp(a) levels are associated with higher risk of all-cause mortality and CVD-death in the general population and in patients with CVD. These findings support the ESC/EAS Guidelines that recommend Lp(a) should be measured at least once in each adult person’s lifetime, since our study suggests those with higher Lp(a) might also have higher risk of mortality.

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Características clínicas asociadas a niveles elevados de lipoproteína(a) en pacientes atendidos por riesgo vascular

Rubio-Serrano,

Gullón Ojesto,

Suárez Fernández

2023

Advances in Laboratory Medicine / Avances en Medicina De Laboratorio

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Resumen Objectivos La lipoproteína(a) (Lp(a)) es cada vez más relevante en la evaluación de pacientes con riesgo vascular debido a su asociación con una mayor incidencia de eventos cardiovasculares. Este estudio tiene como objetivo identificar las características clínicas de los pacientes con niveles elevados de Lp(a) atendidos en consultas externas por riesgo vascular. Métodos Estudio observacional retrospectivo en donde se compararon las características clínicas de los pacientes con niveles elevados de Lp(a) (≥50 mg/dL) con la de los pacientes con valores normales (<50 mg/dL), en un total de 878 pacientes atendidos por riesgo o enfermedad vascular durante los años 2021 y 2022. Resultados Los valores más elevados de Lp(a) se asociaron de forma independiente con una mayor probabilidad de antecedentes de enfermedad arterial periférica (p=0,024), hipercolesterolemia familiar poligénica (HFP, p=0,030) e hipercolesterolemia familiar combinada (HFC, p=0,015), el tratamiento de inhibidores de PCSK9 (p=0,029) y la combinación de estatinas y ezetimiba (p=0,018). Sin embargo, no se obtuvieron diferencias significativas para las variables antecedentes familiares de enfermedad cardiovascular precoz (p=0,143) ni para antecedentes de enfermedad cardiovascular previa (p=0,063) a diferencia de lo identificado en otras series. Conclusiones Los niveles elevados de Lp(a) se asociaron con antecedentes de enfermedad arterial periférica, diagnóstico de HFP y HFC, así como con la necesidad de utilizar tratamientos hipolipemiantes más intensos.

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Real life validation of the European Atherosclerosis Society Consensus Panel lipoprotein(a) threshold of 50mg/dL

Cited by 4 publications

References 9 publications

Relation of High Lipoprotein (a) Concentrations to Platelet Reactivity in Individuals with and Without Coronary Artery Disease

Relation of High Lipoprotein (a) Concentrations to Platelet Reactivity in Individuals with and Without Coronary Artery Disease

Circulating lipoprotein (a) and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis

Características clínicas asociadas a niveles elevados de lipoproteína(a) en pacientes atendidos por riesgo vascular

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