Epidemiology
Elevated Lp(a) shows a consistent positive association with heart failure across 73,410 patients in 8 studies, a systematic review (Heart Fail Rev 2023)
Original title: Lipoprotein(a) and heart failure: a systematic review
This PRISMA-guided systematic review identified 8 eligible studies (7 prospective or retrospective cohorts, 1 cross-sectional), comprising 73,410 patients, examining the association between Lp(a) and heart failure (HF). Five studies analysed populations without HF at baseline and three included patients with HF or left ventricular dysfunction, with endpoints including incident HF, HF hospitalisation, and reduced ejection fraction. Across studies using varied Lp(a) cut-offs and analytic approaches, results were predominantly positive, suggesting elevated Lp(a) is associated with greater HF risk. However, data on HF subtypes (ischaemic versus non-ischaemic, with or without reduced ejection fraction) were poorly reported, and the authors call for further studies to clarify Lp(a) role in this heterogeneous condition.
Original abstract
The role of lipoprotein(a) [Lp(a)] as a possible causal risk factor for atherosclerotic artery disease and aortic valve stenosis has been well established. However, the information on the association between Lp(a) levels and heart failure (HF) is limited and controversial. The main objective of the present study was to assess the association between Lp(a) levels and HF. This systematic review was performed according to PRISMA guidelines. A literature search was performed to detect studies that evaluated the association between Lp(a) levels and HF. Eight studies, including 73,410 patients, were eligible for this research. Seven prospective or retrospective cohorts and one cross-sectional study were analyzed. Five studies analyzed populations without HF; another three included patients with HF or left ventricular dysfunction. The endpoints evaluated varied according to the study analyzed, including incident HF, HF hospitalizations, and decreased left ventricular ejection fraction. Lp(a) levels were also analyzed in different ways, including analysis of Lp(a) as a continuous or categorical variable (distinct cut-off points or percentiles). Globally, the studies included in this review found predominantly positive results. Data on some relevant subgroups, such as HF of ischemic or non-ischemic etiology or HF with or without left ventricular dysfunction, was poorly reported. This systematic review suggests that there would be a positive relationship between Lp(a) levels and HF. Given the complexity and heterogeneity of HF, new studies should be developed to clarify this topic.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.