Epidemiology
Lp(a) at or above 50 mg/dL tracks with younger heart attacks and more diseased coronary vessels in 189 early-onset MI patients (Arch Cardiol Mex 2025)
Original title: Elevated lipoprotein(a) and its association with early-onset myocardial infarction and coronary burden
In a retrospective cohort of 189 patients aged 18 to 55 with early-onset myocardial infarction, those with Lp(a) at or above 50 mg/dL (n = 80) were compared with those below that threshold (n = 109). Elevated Lp(a) was associated with younger age at MI onset (p = 0.0026), a greater number of affected coronary vessels (p = 0.0001), higher smoking prevalence (p = 0.002), less frequent statin use (p < 0.0001), higher BMI (p = 0.0061), higher triglycerides (p = 0.0121), and lower HDL (p < 0.0001). Lp(a) level correlated positively with the number of affected coronary vessels (r = 0.303). The findings reinforce Lp(a) as a marker of both earlier disease onset and a more pro-atherogenic overall lipid profile in young MI patients, supporting its use in risk stratification for this population.
Original abstract
Objectives: Cardiovascular diseases (CVDs) remain a leading cause of morbidity and mortality worldwide, with myocardial infarction (MI) representing one of the most severe manifestations. Lipoprotein(a) [Lp(a)], a genetically influenced lipoprotein subclass, has gained attention for its role in atherogenesis and thrombogenesis. This study investigates clinical and demographic differences in early MI patients with varying Lp(a) levels, dividing them into two groups: Lp(a) < 50 mg/dL and Lp(a) ≥ 50 mg/dL. A retrospective analysis assessed demographic and clinical features, lipid profiles, and comorbidities.
Methods: A retrospective cohort analysis was conducted on 189 patients aged 18-55 years with early-onset MI. Patients were grouped by Lp(a) levels (< 50 mg/dL, n = 109; ≥ 50 mg/dL, n = 80). Clinical parameters analyzed included age at MI onset, number of affected coronary vessels, comorbidities (diabetes mellitus, arterial hypertension, smoking status), statin therapy, and lipid profiles (total cholesterol, triglycerides, HDL, non-HDL, and LDL). Statistical comparisons and correlation analyses were performed to evaluate associations between Lp(a) levels and clinical features.
Results: Elevated Lp(a) levels (≥ 50 mg/dL) were associated with younger MI onset, greater vascular burden, and less frequent statin use. Patients with higher Lp(a) had higher BMI and lower HDL levels. Significant differences were observed in age at MI onset (p = 0.0026), number of affected vessels (p = 0.0001), smoking prevalence (p = 0.002), statin use (p < 0.0001), BMI (p = 0.0061), triglycerides (p = 0.0121), and HDL levels (p < 0.0001). A positive correlation between Lp(a) levels and the number of affected vessels (r = 0.303) was identified.
Conclusion: Elevated Lp(a) levels are strongly associated with younger age at MI onset, increased coronary involvement, and a pro-atherogenic lipid profile. These findings underscore the importance of Lp(a) as a biomarker for risk stratification in MI patients and highlight the need for targeted therapeutic approaches for individuals with high Lp(a) levels.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.