Epidemiology
Patients with abdominal aortic aneurysm have significantly higher Lp(a) than controls, a meta-analysis of 5,078 subjects across 11 studies (Curr Pharm Des 2022)
Original title: Lipoprotein (a) Levels and Abdominal Aortic Aneurysm. A Systematic Review and Meta-analysis
This systematic review and meta-analysis (PRISMA guidelines, search through December 27, 2021) pooled 11 studies (5,078 subjects: 1,637 with abdominal aortic aneurysm (AAA), 3,441 controls; mean age 69.9 years, 85.8% men) examining Lp(a) and AAA. Patients with AAA had significantly higher Lp(a) than controls (standardised mean difference 0.86, 95% CI 0.55-1.17, P<0.001), a result that held in sensitivity analysis excluding three outlying studies (SMD 0.40, 95% CI 0.22-0.58, P<0.001). High Lp(a) was linked to abdominal aortic wall degradation and extracellular matrix disarrangement, and the association with AAA risk held across different racial groups despite variability between them. The findings support elevated Lp(a) as a marker associated with AAA, though the authors call for standardised Lp(a) measurement and further study of its potential as a presymptomatic diagnostic biomarker.
Original abstract
Background: Several studies have linked high Lipoprotein (a) (Lp(a)) concentrations to cardiovascular events, including the formation of Abdominal Aortic Aneurysms (AAA). We review and meta-analyze existing evidence on the association of Lp(a) levels with AAA.
Methods: Studies evaluating the link of Lp(a) with AAA, up to December 27th 2021, were identified by a systematic search of PubMed, SCOPUS, and Web of Science databases. The results were qualitatively and quantitatively synthesized according to PRISMA guidelines. Results are presented as standardized mean differences (SMD) with 95% confidence intervals (CI).
Results: A total of 5,078 subjects (1,637 patients with AAA vs. 3,441 controls) from 11 studies were included in the meta-analysis, with a mean age of 69.9 years and a male sex prevalence of 85.8%. Based on the qualitative synthesis, high Lp(a) concentrations are linked to abdominal aortic wall degradation and extracellular matrix disarrangement. Moreover, despite the considerable variability among races, high Lp(a) levels are related to increased AAA risk, independently of race differences. Accordingly, patients with AAA displayed significantly higher Lp(a) levels compared to controls (SMD: 0.86, 95% CI: 0.55-1.17, p < 0.001). The outcome was not affected in a sensitivity analysis excluding three outlying studies (SMD: 0.40, 95% CI: 0.22-0.58, p < 0.001).
Conclusion: This meta-analysis indicates the association between high Lp(a) levels and the presence of AAA, although existing literature presents high heterogeneity. Further studies are needed to standardize Lp(a) measurements and to conclude whether Lp(a) can be used as a sensitive biomarker of early presymptomatic AAA diagnosis.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.