Epidemiology
Lp(a) above 30 mg/dL raises cardiovascular death risk by 50% in AMI patients aged 80 and older, a prospective cohort of 1,008 patients (Atherosclerosis 2020)
Original title: Lipoprotein(a) and cardiovascular death in oldest-old (≥80 years) patients with acute myocardial infarction: A prospective cohort study
In a prospective cohort of 1,008 patients older than 80 with acute myocardial infarction, enrolled between January 2012 and August 2018 and followed an average of 36.26 months, 287 cardiovascular deaths occurred. Patients with Lp(a) >30 mg/dL had the highest cardiovascular death rate (P<0.05) and the lowest event-free survival on Kaplan-Meier analysis (P=0.030). In a fully adjusted Cox model, Lp(a) >30 mg/dL carried a 1.5-fold higher risk of cardiovascular death compared with Lp(a) <=10 mg/dL (95% CI 1.083-2.132). The findings are the first to show plasma Lp(a) predicts cardiovascular death risk in the oldest-old with acute myocardial infarction, suggesting Lp(a) could be a useful adjunctive risk marker in this advanced-age population.
Original abstract
Background And Aims: Compared with what is known about the prognostic value of lipoprotein(a) [Lp(a)] in middle-aged patients with atherosclerotic cardiovascular disease (ASCVD), less is understood concerning the role of Lp(a) in oldest-old (≥80 years old) with ASCVD. The aim of the present study was to investigate the relationship between Lp(a) and cardiovascular death (CD) among the oldest-old with acute myocardial infarction (AMI).
Methods: A total of 1008 patients with AMI, older than 80 years, were consecutively enrolled between January 2012 and August 2018. The clinical characteristics were collected and Lp(a) concentrations were measured by the immunoturbidimetric method at baseline. The relationship between plasma Lp(a) concentration (≤10 mg/dL, 10-30 mg/dL, >30 mg/dL) and CD was evaluated by Kaplan-Meier analysis and Cox proportional hazard models.
Results: During an average of 36.26 months of follow-up, 287 CD occurred. Data showed that patients with high Lp(a) levels (>30 mg/dL) had the highest rate of CD (p < 0.05). Kaplan-Meier analysis showed that the high Lp(a) group had the lowest event-free survival rate in the oldest-old with AMI (p = 0.030). In addition, subjects with Lp(a) > 30 mg/dL had a 1.5-fold (95% confidence interval: 1.083-2.132) higher risk of CD compared with those with Lp(a) ≤10 mg/dL in fully adjusted Cox proportional hazards model.
Conclusions: The current data firstly showed that plasma Lp(a) concentration was associated with the risk of CD in oldest-old with AMI, suggesting that Lp(a) could be a useful adjunctive measurement in the evaluation of CD in this population.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.