Genetics
Over a quarter of suspected FH patients at a lipid clinic have high-risk Lp(a), which tracks with coronary disease but not carotid plaques, 220-patient study finds (Clin Cardiol 2025)
Original title: Lipoprotein(a) Concentration and Cardiovascular Disease in a Group of Patients With Familial Hypercholesterolemia-A Lipid Clinic Experience
This lipid-clinic study examined 220 patients (110 women, mean age 49.1 years) with suspected familial hypercholesterolaemia to assess Lp(a) prevalence and its association with cardiovascular disease across vascular beds. Cardiovascular disease was present in 24.5% and coronary artery disease (CAD) in 21.4%; both groups had higher Lp(a) than those without (P = 0.0403 and P = 0.0063 respectively), though after adjusting for age and sex, only the CAD association remained significant. Among those undergoing carotid ultrasound, 42.3% had carotid plaques, but Lp(a) levels did not differ by plaque presence nor correlate with carotid intima-media thickness. High-risk Lp(a) (above 0.5 g/L) was present in 28.3% and moderate-risk (0.3-0.5 g/L) in 9.9%, and Lp(a) risk category was significantly associated with cardiovascular disease (P = 0.003) and CAD (P = 0.0004) but not carotid plaques. The authors conclude elevated Lp(a) is highly prevalent in this hyperlipidaemic population and strongly linked to coronary, but not carotid, atherosclerosis.
Original abstract
Background: High Lp(a) concentrations are linked to an increased risk of cardiovascular disease (CVD). However, more evidence is needed to assess the association of Lp(a) with CVD in different vascular beds.
Hypothesis: The aim was to assess the prevalence of increased Lp(a) levels and the association between Lp(a) levels and CVD in hypercholesterolemic patients.
Methods: We examined 220 patients (110 women) with suspicion of FH. The mean (SD) age was 49.1 (15.02) years, LDL-C 3.49 (1.75) mmol/L, and the median (IR) Lp(a) concentration 0.15 (0.53) g/L.
Results: CVD was present in 24.5%, coronary artery disease (CAD) in 21.4% of the examined individuals. Patients with CVD and patients with CAD had higher Lp(a) levels than patients without these diseases (p = 0.0403 and p = 0.0063, respectively); however, after adjustment for age and sex, only the difference in Lp(a) concentrations between persons with and without CAD remained significant. In total, 42.3% of patients who underwent carotid ultrasound examination had carotid plaques. We did not observe differences in Lp(a) levels between patients with or without plaques or correlations between Lp(a) and carotid IMT. In total, 28.3% of patients had Lp(a) concentrations in the high (> 0.5 g/dL), and 9.9% in the moderate-risk category (0.3-0.5 g/L). We observed an association between Lp(a) risk categories and the presence of CVD (p = 0.003) and CAD (p = 0.0004) but not with the presence of carotid plaques.
Conclusions: We found a high prevalence of increased Lp(a) levels in a group of hyperlipidemic persons and strong associations of Lp(a) risk categories with CAD but not with carotid atherosclerosis.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.