Mechanisms
Systematic review of 26 studies finds Mendelian randomisation but not observational data supports a causal role for Lp(a) in atrial fibrillation (Pol Arch Intern Med 2025)
Original title: The role of lipoprotein(a) in atrial fibrillation: a systematic review
This PRISMA 2020 systematic review searched five databases and analysed 26 original clinical studies on the relationship between Lp(a) and atrial fibrillation (AF). Observational studies on Lp(a) level and AF incidence gave conflicting results, but Mendelian randomisation studies consistently supported a causal association between elevated Lp(a) and AF. AF patients who experienced stroke or other thromboembolic events tended to have higher Lp(a) levels than those without such events. The review concludes Lp(a) likely has a pathophysiological role in AF, particularly around thromboembolic complications, but flags the inconsistent observational evidence as a reason for further dedicated study.
Original abstract
Introduction: Atrial fibrillation (AF) is the most prevalent form of cardiac arrhythmia worldwide. Early diagnosis and treatment are essential, emphasizing the need to develop novel biomarkers. Lipoprotein(a) (Lp[a]) has recently been widely investigated as a potential risk factor for various cardiovascular conditions, including AF.
Objectives: Our objective was to systematically review the current knowledge on the role of Lp(a) in AF.
Methods: This systematic review adhered to the PRISMA 2020 guidelines. We included full‑text original clinical studies in English assessing the role of Lp(a) in AF. A comprehensive search in 5 databases: Embase, MEDLINE Ultimate, PubMed, Scopus, and Web of Science yielded 26 original, relevant clinical research articles that we analyzed in this study.
Results: Studies investigating the association between Lp(a) level and the incidence of AF present conflicting findings. However, Mendelian randomization studies advocate a causal association between high Lp(a) levels and AF. Research data suggest that AF patients who experience stroke or other thromboembolic events tend to have higher Lp(a) levels than those not experiencing such events.
Conclusions: Existing data suggest Lp(a) may play a pathophysiological role in AF patients, especially those who experience thromboembolic events. Nevertheless, this field requires further research due to inconsistencies in the existing evidence.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.