Epidemiology
Lp(a) distribution varies by ethnicity and sex in 521 hospitalised Singaporean patients with ischaemic heart disease (Ther Adv Cardiovasc Dis 2024)
Original title: Lipoprotein(a) distribution in hospitalised Asian patients with ischaemic heart disease
In a retrospective, single-centre cohort of 521 patients admitted with ischaemic heart disease (IHD) in Singapore (82.2% men, 46.6% newly diagnosed, 10% premature IHD), median Lp(a) was 35.2 nmol/L, with 70.8% of patients in the normal range (<70 nmol/L), 13.4% between 70 and 120 nmol/L, and 15.7% at 120 nmol/L or above. Lp(a) distribution was right-skewed across all ethnicities, and patients of Indian ethnicity and women had higher Lp(a) levels than other groups. Multivariable analysis identified very high Lp(a) as independently associated with premature onset of IHD (OR 2.90, 95% CI 1.26-6.67, P=0.012). The findings highlight ethnicity- and sex-specific differences in Lp(a) burden relevant to risk stratification in Asian populations.
Original abstract
Background: Elevated lipoprotein(a) [Lp(a)] is a common hyperlipidaemic condition with strong genetic predisposition and is independently associated with ischaemic heart disease (IHD). A Mendelian randomisation study has suggested that elevated Lp(a) is likely to confer similar causal risks as heterozygous familial hypercholesterolemia for premature IHD. We aimed to characterise the clinical profiles of admitted patients with IHD with at least one Lp(a) measurement. We also investigated whether elevated Lp(a) concentration was associated with premature onset of IHD.
Methods: This is a descriptive, non-interventional, retrospective study with data from a single tertiary hospital IHD Lp(a) cohort in Singapore, which consecutively recruited 521 patients with IHD admitted to the hospital.
Results: A total of 82.2% were men, 46.6% had newly diagnosed IHD and 10% had premature IHD. The median Lp(a) levels was 35.2 nmol/L. 70.8% of patients had normal Lp(a) concentrations (<70 nmol/L), 13.4% of people with Lp(a) ⩾ 70 to <120 nmol/L and 15.7% of patients with Lp(a) ⩾ 120 nmol/L. Lp(a) distribution was positively skewed to the right for all ethnicities. Patients of Indian ethnicity and of female gender had higher levels of Lp(a) compared with other ethnicities and gender, respectively. Multivariable regression analysis identified Lp(a) ⩾ 155 mmol/L to be associated with development of premature IHD (OR = 2.90, 95% CI: 1.26-6.67, p = 0.012).
Conclusion: There exist differences in Lp(a) distribution across ethnicities and gender. The subgroup analysis suggests that Lp(a) ⩾ 155 mmol/L was associated with premature onset of IHD.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.