The association between lipoprotein(a) and atrial fibrillation: A systemic review and meta‐analysis

Abstract

Lipoprotein(a) (Lp[a]) is a particle consisting of a low‐density lipoprotein (LDL)‐like core connected to an apolipoprotein(a) chain, which is an established risk factor for cardiovascular disease. However, studies addressing the relationship between atrial fibrillation (AF) and Lp(a) demonstrated conflicted results. Thus, we sought to evaluate this relationship by conducting this systemic review and meta‐analysis. We performed a comprehensive systematic search of health science databases, including PubMed, Embase, Cochrane Library, Web of Science, MEDLINE, and ScienceDirect, to identify all relevant literature from their inception to March 1, 2023. We identified nine related articles, which were eventually included in this study. Our study showed no association between Lp(a) with new‐onset AF (HR = 1.45, 95% confidence interval [CI]: 0.57–3.67, p = .432). In addition, genetically elevated Lp(a) was not associated with the risk of atrial fibrillation (OR = 1.00, 95% CI: 1.00–1.00, p = .461). Different stratification of Lp(a) levels may have different outcomes. Also, higher Lp(a) levels may be inversely associated with the risk of developing AF compared to those with lower levels. Lp(a) levels were not associated with incident AF. Further research is needed to identify the mechanism underlying these results and better understand Lp(a) stratification for AF and the possible inverse association between Lp(a) and AF.

Assessment of Serum Lipoprotein(a) Status in Type 2 Diabetes Mellitus

“…Lipoprotein(a) or Lp(a) is a glycoprotein synthesized in the liver, formed from a molecule analogous to low-density lipoprotein (LDL), associated with an apolipoprotein a (apo a) molecule. Like LDL, Lp(a) is made up of a protein part, apolipoprotein B100 (apo B100) linked to apo a by a disulfide bridge and a lipid part rich in cholesterol, cholesterol esters and in phospholipids [2,3]. Lp(a) consists of an atherogenic LDL lipoparticle and a potentially thrombogenic apo a and its causal role as a risk factor for cardiovascular disease has been well established [3,4].…”

“…Like LDL, Lp(a) is made up of a protein part, apolipoprotein B100 (apo B100) linked to apo a by a disulfide bridge and a lipid part rich in cholesterol, cholesterol esters and in phospholipids [2,3]. Lp(a) consists of an atherogenic LDL lipoparticle and a potentially thrombogenic apo a and its causal role as a risk factor for cardiovascular disease has been well established [3,4]. A subtype of LDL, it therefore constitutes a lipoprotein of interest and an independent cardiovascular risk factor little evaluated in Africa and in Senegal in particular.…”

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

“…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].…”