Epidemiology
Lp(a) at or above 30 mg/dL predicts coronary disease in women but not men, while 50 mg/dL works for both, in 1,858 Turkish patients (Clin Cardiol 2024)
Original title: Is There a Need for Sex-Tailored Lipoprotein(a) Cut-Off Values for Coronary Artery Disease Risk Stratification?
In 1,858 patients (mean age 54 years, 53.33% women) with Lp(a) measurements at Koc University Hospital, Lp(a) was an independent predictor of coronary artery disease (CAD) in the overall cohort using both the 30 mg/dL and 50 mg/dL thresholds (both P < 0.001). In sex-specific analysis, however, Lp(a) at or above 30 mg/dL independently predicted CAD only in women (P < 0.001), not men, while Lp(a) at or above 50 mg/dL predicted CAD in both men (P = 0.004) and women (P = 0.047). The findings suggest a lower Lp(a) threshold may already carry meaningful cardiovascular risk in women that is not yet apparent in men at the same level, supporting the case for sex-specific Lp(a) cutoffs in coronary risk stratification rather than a single universal threshold.
Original abstract
Background: Lipoprotein(a) [Lp(a)] plasma level is a well-known risk factor for coronary artery disease (CAD). Existing data regarding the influence of sex on the Lp(a)-CAD relationship are inconsistent.
Objective: To investigate the relationship between Lp(a) and CAD in men and women and to elucidate any sex-specific differences that may exist.
Methods: Data of patients with Lp(a) measurements who were admitted to a tertiary university hospital, Koc University Hospital, were analyzed. The relationship between Lp(a) levels and CAD was explored in all patients and in subgroups created by sex. Two commonly accepted Lp(a) thresholds ≥ 30 and ≥ 50 mg/dL were analyzed.
Results: A total of 1858 patients (mean age 54 ± 17 years; 53.33% females) were included in the analysis. Lp(a) was an independent predictor of CAD according to the multivariate regression model for the entire cohort. In all cohort, both cut-off values (≥ 30 and ≥ 50 mg/dL) were detected as independent predictors of CAD (p < 0.001). In sex-specific analysis, an Lp(a) ≥ 30 mg/dL was an independent predictor of CAD only in women (p < 0.001), but Lp(a) ≥ 50 mg/dL was a CAD predictor both in men and women (men, p = 0.004; women, p = 0.047).
Conclusion: The findings of this study may suggest that different thresholds of Lp(a) level can be employed for risk stratification in women compared to men.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.