Epidemiology
Lp(a) is not linked to diastolic dysfunction with preserved ejection fraction, but statin therapy is protective, 1,492-patient Mayo Clinic study finds (High Blood Press Cardiovasc Prev 2025)
Original title: Association Between Elevated Lipoprotein(a) and Diastolic Dysfunction: A Retrospective Cohort Study
This retrospective cohort study analysed 1,492 adults (median age 59) with both an Lp(a) measurement and an echocardiogram between 1997 and 2024, testing whether elevated Lp(a) (50 mg/dL or above) is associated with diastolic dysfunction (three or more abnormal echo parameters) in patients with preserved ejection fraction. Diastolic dysfunction was present in 77 patients (5.1%). Elevated Lp(a) was not associated with diastolic dysfunction (adjusted OR 0.89, 95% CI 0.49-1.54), whereas age (aOR 1.03, P = 0.026), hypertension (aOR 1.83, P = 0.042), diabetes (aOR 2.43, P = 0.002) and cardiovascular disease (aOR 1.90, P = 0.043) were each associated with higher risk, and statin therapy was associated with lower risk (aOR 0.51, P = 0.016). The authors conclude Lp(a) does not appear to drive diastolic dysfunction in preserved-ejection-fraction patients, and emphasise that managing traditional cardiovascular risk factors remains the priority in this setting.
Original abstract
Introduction: Lipoprotein(a) [Lp(a)] has been linked to myocardial fibrosis and endothelial dysfunction, proposed mechanisms for diastolic dysfunction (DD). This study assessed the association between elevated Lp(a) (≥ 50 mg/dL) and DD in patients with preserved ejection fraction (EF).
Aim: We analyzed 1492 adults (median age59) with an Lp(a) measurement and echocardiogram (1997-2024).
Methods: Diastolicdysfunction required ≥ 3 abnormal echo parameters, as per recent guidelines. Logisticregression adjusting for potential confounders was performed.
Results: Seventy-sevenpatients (5.1%) had DD. Lp(a) ≥ 50 mg/dL was not associated with DD [adjusted oddsratio (aOR): 0.89, 95% confidence interval (CI): 0.49-1.54]. However, age (aOR:1.03, p = 0.026), hypertension (aOR: 1.83, p = 0.042), diabetes mellitus (aOR: 2.43, p =0.002), and cardiovascular (CV) diseases (aOR: 1.90, p = 0.043) were associated withDD, while statin therapy was associated with reduced risk (aOR: 0.51, p = 0.016).
Conclusions: In the setting of preserved EF, Lp(a) was not associated with DD,emphasizing management of traditional CV risks.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.