Patients with elevated Lp(a) (>125 nmol/L) face very high cardiovascular risk, with early events in 65% of women and 56% of men, in 316 Spanish patients (Clin Investig Arterioscler 2024)

Original title: Clinical-epidemiological analysis of patients with elevated lipoprotein A in a third level hospital

Clin Investig Arterioscler · 30 December 2023 · 5

García de Prada M, Costa Segovia R, de Castro Martínez M, Valdeolivas Hidalgo N, Sánchez López MB, Blanco Echevarría A

In a cross-sectional study of 316 patients with elevated Lp(a) (>125 nmol/L) at a Spanish tertiary hospital (mean age 59 years, 56% men), 57.7% had established cardiovascular disease, 16.3% polyvascular disease, and 11.7% subclinical disease; mean Lp(a) was 260 nmol/L. Most patients were on lipid-lowering therapy (89% statins, 68.6% ezetimibe, 13.7% PCSK9 inhibitors), and among those with established cardiovascular disease, 98.3% were treated and 86.4% were on antiplatelet therapy. Cardiovascular events occurred early, at a mean age of 55 years in men and 60 years in women, with 65.1% of affected women and 56.2% of affected men experiencing an early event. The findings confirm that elevated Lp(a) marks a population at very high risk of early cardiovascular disease requiring intensive management.

Original abstract

Objective: The objective of the study is to describe the clinical and epidemiological characteristics of our patients with elevated Lp(a).

Materials And Methods: A descriptive cross-sectional study was conducted on 316 patients with elevated Lp(a) (>125 nmol/L) in a random sample between January and August 2022. We measured epidemiological, anthropometric, clinical and laboratory variables (lipid metabolism parameters, carbohydrates and hormones).

Results: Mean age of our sample subject's was 59 ± 15 years with 56% males. The average BMI was 27.6 kg/m2 (71% with elevated BMI). Elevated waist circumference was observed in 54.1% of men and 77.8% of women. 48% had hypertension, 30.7% had diabetes mellitus and 91.5% dyslipidemia. Only 39.7% of the patients had never smoked. The mean values of total cholesterol were 158 ± 45 mg/dl, LDL was 81 ± 39 mg/dl, HDL was 53 ± 17 mg/dl, Triglycerides were 127 ± 61 mg/dl, and Lp(a) was 260 ± 129 nmol/L. Regarding lipid lowering treatment, 89% were on statins, 68.6% on ezetimibe, and 13.7% on PCSK9 inhibitors. 177 patients (57,7%) had established cardiovascular disease (CVD), 16.3% had polyvascular disease, 11.7% had subclinical CVD, and 30.6% had no known CVD. Among patients with established CVD, 174 (98.3%) were on lipid-lowering treatment (97.2% on statins) and 86.4% were on antiplatelet therapy. The mean age of cardiovascular events was 55 ± 12 years in males and 60 ± 11 years in females. 65,1% of female and 56,2% of male patients suffered an early cardiovascular event.

Conclusions: Patients with elevated Lp(a) are at very high cardiovascular risk, particularly for early cardiovascular disease.

Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.