Epidemiology
Lp(a) levels are significantly higher in patients with premature coronary artery disease, a meta-analysis of 11 case-control studies (Coron Artery Dis 2023)
Original title: Lipoprotein(a) is associated with premature coronary artery disease: a meta-analysis
This systematic review and meta-analysis pooled 11 case-control studies comparing Lp(a) levels between patients with premature coronary artery disease (pCAD) and controls. Lp(a) concentration was significantly higher in pCAD patients than controls (standardised mean difference 0.97, 95% CI 0.52-1.42, P<0.0001, I2=98%). The authors note that high statistical heterogeneity and the relatively small, moderate-quality case-control studies included are limitations. The findings confirm elevated Lp(a) as a marker associated with premature coronary artery disease, though further studies are needed to establish its clinical significance in this population.
Original abstract
Background: Lipoprotein(a) is associated with adverse cardiovascular outcomes and its association with premature coronary artery disease (pCAD) is underexamined. The primary aim of the study is to compare serum lipoprotein(a) levels between pCAD cases and controls.
Methods: We conducted a systematic review and the MEDLINE database, ClinicalTrials.gov, medRxiv and Cochrane Library were searched for studies evaluating lipoprotein(a) and pCAD. Standardized mean differences (SMD) of lipoprotein(a) in pCAD patients versus the controls were pooled by a random-effects meta-analysis. The presence of statistical heterogeneity was evaluated with the Cochran Q chi-square test and the quality of the included studies was assessed via the Newcastle-Ottawa Scale.
Results: A total of 11 studies were found eligible, reporting on the difference in lipoprotein(a) levels between pCAD patients and controls. Serum lipoprotein(a) concentration was found significantly increased in patients with pCAD (SMD = 0.97; 95% confidence intervals, 0.52-1.42; P < 0.0001; I2 = 98%) as compared to controls. High statistical heterogeneity and relatively small case-control studies of moderate quality are the main limitations of this meta-analysis.
Conclusion: Lipoprotein(a) levels are significantly increased in patients with pCAD as compared to controls. Further studies are needed to clarify the clinical significance of this finding.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.