Epidemiology
Lp(a) of 30 mg/dL or above raises coronary heart disease risk but not stroke risk in Japan's Suita Study of 5,138 adults (J Atheroscler Thromb 2025)
Original title: Lipoprotein(a) Levels and the Risk of Coronary Heart Disease and Stroke: The Suita Study
This analysis drew on the Suita Study, a Japanese population-based prospective cohort of 5,138 adults aged 30 or older free of coronary heart disease (CHD) or stroke at baseline, of whom only 17.0% had Lp(a) at or above 30 mg/dL, to test the association between Lp(a) and incident CHD and stroke. Over a median 11.7-year follow-up, 164 CHD and 234 stroke events occurred. Lp(a) of 30 mg/dL or above was associated with increased CHD risk (HR 1.52, 95% CI 1.05-2.21), and each 10 mg/dL increment in Lp(a) raised CHD risk by 7.9%, an association that held after adjusting for total cholesterol or lipid-lowering drug use. In contrast, elevated Lp(a) was not associated with stroke risk or any stroke subtype. This is among the few large prospective studies establishing an Lp(a)-CHD threshold specifically in a Japanese population, where Lp(a) distribution differs from Western cohorts.
Original abstract
Aims: Lipoprotein(a) (Lp[a]) exhibits atherogenic and thrombogenic properties. We investigated the association between Lp(a) levels and the risk of coronary heart disease (CHD) and stroke.
Methods: We used data from 5138 people ≥ 30 years old registered in the Suita Study, a Japanese population-based prospective cohort study. All participants were initially free from CHD or stroke. Cox proportional hazard models were applied to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for CHD and stroke among participants with elevated Lp(a) levels.
Results: At baseline, only 17.0% of participants had Lp(a) levels ≥ 30 mg/dL. Within the median follow-up period of 11.7 years, 164 CHD and 234 stroke events were detected. In the multivariable-adjusted regression model, Lp(a) ≥ 30 mg/dL was associated with an increased risk of CHD (HR, 1.52 [95% CI, 1.05-2.21]). Every 10-ml/dL increment in Lp(a) level was associated with a 7.9% increase in CHD risk. The association with CHD did not change significantly after adjusting for total cholesterol level or lipid-lowering drugs. In contrast, increased Lp(a) levels were not associated with stroke risk or any subtype.
Conclusions: Lp(a) ≥ 30 mg/dL was associated with an increased risk of CHD in the Japanese population.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.