Epidemiology
Nearly 19% of a Korean general-population cohort showed coronary calcium progression, and higher Lp(a) tertiles tracked with it, 2,750-person study finds (Korean J Fam Med 2025)
Original title: Association of lipoprotein(a) with progression of coronary artery calcification: retrospective longitudinal study
This retrospective longitudinal study grouped 2,750 Korean participants without established ASCVD by Lp(a) level to test its association with coronary artery calcification (CAC) progression, defined as incident CAC or a rise of 2.5 or more in the square-root-transformed calcium score between baseline and follow-up. Over an average 3.07-year follow-up, 18.98% of participants experienced CAC progression, and those with progression had notably higher Lp(a). Higher Lp(a) tertiles correlated with higher baseline and follow-up calcium scores and with the percentage of CAC progression, and this association with CAC progression remained significant after adjustment, though it lost significance once the calcium-score change was annualised for follow-up duration. The authors conclude elevated Lp(a) is associated with CAC progression in a general Korean population without ASCVD, but call for longer-term studies and Korean-specific Lp(a) thresholds to establish its predictive value more definitively.
Original abstract
Background: Atherosclerotic cardiovascular disease (ASCVD) is a major health concern, and lipoprotein(a) (Lp(a)) is an independent risk factor. However, there is limited evidence regarding Lp(a) and the risk of ASCVD in Asian populations. This study aimed to assess the predictive value of changes in coronary artery calcification (CAC) for ASCVD risk associated with Lp(a) level.
Methods: Participants (n=2,750) were grouped according to their Lp(a) levels, and the association between Lp(a) and CAC progression was examined. CAC progression was defined as the occurrence of incident CAC or a difference ≥2.5 between the square root (√) of baseline and follow-up coronary artery calcium scores (CACSs) (Δ√transformed CACS). To adjust for differences in follow-up periods, Δ√transformed CACS was divided by the follow- up period (in years).
Results: Over an average follow-up of 3.07 years, 18.98% of participants experienced CAC progression. Those with disease progression had notably higher Lp(a) levels. Higher Lp(a) tertiles correlated with increased baseline and follow-up CACS, CAC progression (%), and Δ√transformed CACS. Even after adjustment, higher Lp(a) levels were associated with CAC progression. However, annualized Δ√transformed CACS analysis yielded no significant results.
Conclusion: This study demonstrated an association between elevated Lp(a) levels and CAC progression in a general population without ASCVD. However, longer-term follow-up studies are needed to obtain meaningful results regarding CAC progression. Further research is necessary to utilize Lp(a) level as a predictor of cardiovascular disease and to establish clinically relevant thresholds specific to the Korean population.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.