Epidemiology
High Lp(a) independently predicts polyvascular disease in patients undergoing bypass surgery, a Korean study of 470 patients (Atherosclerosis 2011)
Original title: Increased lipoprotein(a) is associated with polyvascular disease in patients undergoing coronary artery bypass graft
This prospective study enrolled 470 patients (329 men, 141 women) undergoing coronary artery bypass grafting (CABG) to identify predictors of polyvascular disease, defined as symptomatic or asymptomatic carotid or peripheral artery disease, present in 32.1% of patients (151 of 470). Lp(a) was the only biochemical marker independently associated with polyvascular disease (odds ratio 1.01 per 1 mg/dL increase, 95% CI 1.00-1.01), alongside age 65 or older, male sex, hypertension, smoking history, and low BMI. The highest Lp(a) quartile was significantly associated with involvement of two or more vascular territories (odds ratio 1.866, 95% CI 1.056-3.297) and three vascular territories (odds ratio 4.240, 95% CI 1.405-12.798), with a significant trend toward more advanced polyvascular disease at higher Lp(a) (P for trend=0.008 for three-territory involvement). The findings show high Lp(a) independently predicts polyvascular disease in CABG patients, suggesting a role for Lp(a) in disease affecting multiple vascular beds.
Original abstract
Objective: We sought to identify clinical and biochemical predictors of disease in multiple vascular territories, in patients with established coronary heart disease.
Methods: A total of 470 patients (329 men, 141 female) who had undergone coronary artery bypass grafting (CABG) were enrolled in this prospective study. Polyvascular disease was defined on the presence of existing symptomatic or asymptomatic carotid artery stenosis and/or peripheral artery disease, which is present in 32.1% of patients (n=151).
Results: Clinical and laboratory features independently associated with the presence of polyvascular disease included age ≥65 years, male sex, hypertension, former or current smoker, low BMI, and high Lp(a). Lp(a) was the only biochemical marker that had an independent association with polyvascular disease (OR=1.01 per 1mg/dl increase; 95% CI, 1.00-1.01). The fourth quartile of Lp(a) has significant associations with the risk of two or more vascular territories involvement (OR=1.866; 95% CI, 1.056-3.297), and three vascular territories involvement (OR=4.240; 95% CI, 1.405-12.798). There was a significant trend towards patients with the highest quartile of Lp(a) that has association with more advanced polyvascular disease (test for trend: p=0.008 for involvement of three vascular territories).
Conclusion: High Lp(a) was independently associated with polyvascular disease in patients who undergo CABG, which is suggestive of an indirect evidence of the pathophysiologic function of Lp(a) in polyvascular disease.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.