Epidemiology
Very high Lp(a) (>100 mg/dL) predicts multivessel coronary disease and a stepwise rise in in-hospital mortality after heart attack, the French RICO survey of 1,213 patients (J Clin Lipidol 2022)
Original title: High lipoprotein(a) levels predict severity of coronary artery disease in patients hospitalized for acute myocardial infarction. Data from the French RICO survey
In 1,213 consecutive patients hospitalised for acute myocardial infarction in the French RICO regional registry (2019-2020), the prevalence of high (>=50-<=100 mg/dL) and very high (>100 mg/dL) Lp(a) was 13% and 6% respectively. Patients with high or very high Lp(a) were more often on statins, had lower corrected LDL cholesterol, and higher rates of prior atherosclerotic cardiovascular disease. Very high Lp(a) was associated with higher SYNTAX scores and more frequent multivessel disease, with the odds of multivessel disease highest in patients with Lp(a) >100 mg/dL, and in-hospital deaths increased stepwise across the three Lp(a) groups (P=0.028). The findings support systematic Lp(a) screening in patients hospitalised for acute myocardial infarction to identify those with a more severe coronary disease burden.
Original abstract
Background: Lipoprotein(a) (Lp(a)) is a well-recognized independent risk factor for atherosclerotic cardiovascular disease (ASCVD). However, limited data are available on the relationship between coronary artery disease (CAD) burden and Lp(a) levels in patients with acute myocardial infarction (MI).
Objective: The objective of this study was to assess the severity of CAD according to Lp(a) levels from a French regional registry of acute MI.
Methods: CAD burden was assessed in 1213 consecutive patients hospitalized for acute MI in 2019-2020 who underwent coronary angiography. Patients were compared according to their Lp(a) levels: <50 mg/dL (normal), ≥50 mg/dL and ≤100 mg/dL (high) and >100 mg/dL (very high).
Results: The prevalence of high and very high Lp(a) was 13% and 6%, respectively. Median age, and rates of diabetes and smoking were similar in all groups. Patients with high or very high Lp(a) were more often under statin therapy, their corrected LDL-cholesterol levels were lower and previous ASCVD rates higher. When compared with lower levels, patients with very high Lp(a) levels had more elevated SYNTAX scores and more frequent multivessel disease. By multivariate logistic regression analysis, the odd ratio for the estimate of multivessel disease was the highest for patients with Lp(a) >100 mg/dL. Moreover, there was a gradual increase in the number of in-hospital deaths across the three Lp(a) groups (p=0.028).
Conclusions: In real-world patients hospitalized for acute MI in France, very high Lp(a) levels are independently associated with a severe CAD burden, supporting the need for systematic screening of Lp(a) in these patients.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.