Epidemiology
Elevated Lp(a) predicts both coronary disease severity and 7-year MACE risk in 4,332 patients with type 2 diabetes (Heliyon 2024)
Original title: Correlation between circulating lipoprotein(a) levels and cardiovascular events risk in patients with type 2 diabetes
In 4,332 patients with type 2 diabetes who underwent coronary angiography, circulating Lp(a) was significantly higher in those with coronary heart disease (CHD) than without, and correlated positively with disease severity. Elevated Lp(a) was associated with CHD occurrence (odds ratio 1.597, 95% CI 1.354-1.893, P < 0.001), triple-vessel versus single-vessel disease (odds ratio 1.908, 95% CI 1.401-2.711, P < 0.001), and high versus low Gensini score (odds ratio 2.002, 95% CI 1.514-2.881, P < 0.001). Over 7 years of follow-up, multivariate Cox regression found elevated Lp(a) independently associated with major adverse cardiovascular events (hazard ratio 1.915, 95% CI 1.571-2.493, P < 0.001). Circulating Lp(a) tracks with both coronary lesion burden and long-term cardiovascular event risk in type 2 diabetes, supporting its use in risk stratification for this population.
Original abstract
Background: High circulatory lipoprotein(a) [Lp(a)] concentration promotes atherosclerosis; however, its efficacy in predicting the extent of atherosclerotic coronary heart disease (CHD) with coronary artery obstruction and major adverse cardiovascular events (MACEs) in diabetic patients remains questionable. This study aimed to examine whether elevated circulating Lp(a) levels exacerbate CHD and to assess their utility in predicting MACEs in individuals diagnosed with type 2 diabetes mellitus (T2DM).
Methods: In total, 4332 patients diagnosed with T2DM who underwent coronary angiography (CAG) were included and categorized into two groups (CHD and non-CHD) based on the CAG results. We used a correlation analysis to explore the potential links between the levels of circulating Lp(a) and CHD severity. Cox regression analysis was performed to evaluate MACEs.
Results: The concentrations of circulating Lp(a) were markedly elevated in the CHD group and positively correlated with disease severity. Our results indicate that elevated circulating Lp(a) is a crucial risk factor that significantly contributes to both the progression and severity of CHD. The differences between the two groups are evident in the risk of CHD occurrence [odds ratio (OR) = 1.597, 95 % confidence interval (CI): 1.354-1.893, p < 0.001], the different levels of vessel involvement (OR = 1.908 for triple-vessel vs. single-vessel disease, 95 % CI: 1.401-2.711, p < 0.001), and their relation to the Gensini Score (OR = 2.002 for high vs. low GS, 95 % CI: 1.514-2.881, p < 0.001). Over the course of the 7-year follow-up period, the multivariate Cox regression analysis indicated that increased levels Lp(a) levels are independently associated with the occurrence of MACEs [hazard ratio (HR) = 1.915, 95 % CI: 1.571-2.493, p < 0.001].
Conclusion: We confirmed a positive correlation among circulating Lp(a) levels, CHD lesions count, and Gensini scores. Moreover, Lp(a) levels have predictive significance for the occurrence of MACEs in T2DM patients.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.