Epidemiology
Highest Lp(a) quartile carries 19% higher MACE risk and 57% higher mortality in 8,382 Chinese hospitalised cardiovascular patients (Eur J Med Res 2024)
Original title: The levels of serum lipoprotein(a) on clinical outcomes in Chinese hospitalized patients with cardiovascular diseases
In a retrospective study of 8,382 patients hospitalised with cardiovascular disease at Dongguan People's Hospital in China between 2016 and 2021, divided into four Lp(a) quartiles (up to 80.00 mg/L; 80.01-160.90 mg/L; 160.91-336.41 mg/L; above 336.41 mg/L), 1,361 patients (16.2%) developed major adverse cardiovascular events (MACE) and 125 (1.5%) died from any cause over an average follow-up of 619 days. MACE incidence rose across quartiles from 7.65 to 10.75 per 100 person-years, and all-cause mortality rose from 0.48 to 1.18 per 100 person-years. Multivariate Cox regression confirmed high Lp(a) as an independent risk factor for both MACE (hazard ratio 1.189, 95% CI 1.045-1.353, P = 0.030) and all-cause death (hazard ratio 1.573, 95% CI 1.009-2.452, P = 0.046). Beyond traditional lipid measures, higher Lp(a) independently predicts worse cardiovascular outcomes and mortality in Chinese hospitalised patients, supporting its consideration as a target for atherosclerotic disease prevention.
Original abstract
Objective: Serum lipoprotein(a) [Lp(a)] is a risk factor of cardiovascular diseases. However, the relationship between the serum Lp(a) and clinical outcomes has been seldom studied in Chinese hospitalized patients with cardiovascular diseases.
Methods: We retrospectively collected the clinical data of hospitalized patients with cardiovascular diseases in the Cardiovascular Department of Dongguan People's Hospital from 2016 to 2021 through the electronic case system. Patients were divided into 4 groups based on Lp(a) quartiles: Quartile1 (≤ 80.00 mg/L), Quartile 2 (80.01 ~ 160.90 mg/L), Quartile 3 (160.91 ~ 336.41 mg/L), Quartile 4 (> 336.41 mg/L). Cox proportional hazard regression models were constructed to examine the relationship between Lp(a) and cardiovascular events.
Results: A total of 8382 patients were included in this study. After an average follow-up of 619 (320 to 1061) days, 1361 (16.2%) patients developed major adverse cardiovascular events, and 125 (1.5%) all-cause death were collected. The incidence of MACEs was 7.65, 8.24, 9.73 and 10.75 per 100 person-years in each Lp(a) quartile, respectively; the all-cause mortality was 0.48, 0.69, 0.64 and 1.18 per 100 person-years in each Lp(a) quartile, respectively. The multivariate Cox regression analysis suggested that high Lp(a) level was an independent risk factor for MACEs (HR: 1.189, [95% CI: 1.045 to 1.353], P = 0.030) and all-cause death (HR: 1.573, [95% CI: 1.009 to 2.452], P = 0.046).
Conclusion: In addition to traditional lipid indicators, higher Lp(a) exhibited higher risks of adverse cardiovascular events and death, indicated worse prognosis. Lp(a) may be a new target for the prevention of atherosclerotic diseases.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.