Testing
Women have higher Lp(a) than men in acute coronary syndrome, Portuguese cohort of 388 (Rev Port Cardiol 2026)
Original title: Lipoprotein(a) and acute coronary syndrome: Associations with sex, age and traditional cardiovascular risk factors
Cross-sectional study of patients admitted with acute coronary syndrome (ACS) at a Portuguese centre (January 2022-December 2023); of 903 ACS admissions, Lp(a) was measured in 388 (42%). Median Lp(a) was 62.0 nmol/L (IQR 18.4-153.8), and 38.7% had Lp(a) above 100 nmol/L. Women had higher Lp(a) than men overall (p-trend=0.014) and among patients without traditional cardiovascular risk factors (p=0.003). Lp(a) levels did not differ across traditional risk factor categories, but elevated Lp(a) was associated with a prior history of coronary artery disease (p-trend=0.003) and with high-intensity statin use alone (p-trend=0.032) or combined with ezetimibe (p-trend=0.014). The authors conclude Lp(a)'s heterogeneous, risk-factor-independent distribution reinforces its role as an independent risk factor and supports active Lp(a) screening in ACS patients, particularly women without traditional risk factors.
Original abstract
Introduction And Objectives: Lipoprotein(a) [Lp(a)] is recognized as an independent risk factor for coronary disease owing to its atherogenic, proinflammatory, and prothrombotic properties. Current guidelines recommend a single measurement in adults to refine cardiovascular (CV) risk assessment. We aimed to characterize Lp(a) levels in patients with acute coronary syndrome (ACS) and explore associations with sex, age, comorbidities, and traditional cardiovascular risk factors.
Methods: We conducted a cross-sectional study of patients with ACS admitted to our center between January 2022 and December 2023, with Lp(a) measured at admission. Patients were stratified into two groups: Lp(a) >100 nmol/L and ≤100 nmol/L. Demographic and clinical data, including traditional cardiovascular risk factors (dyslipidemia, diabetes mellitus, arterial hypertension, smoking, and obesity), were collected from hospital records. Chi-square and independent T or Mann-Whitney U tests were used to compare categorical and quantitative variables; linear regression analysis assessed associations between continuous Lp(a) values and independent variables.
Results: Among 903 patients admitted with ACS during the study period, Lp(a) was measured in 388 (42%). Median Lp(a) level was 62.0 [18.4, 153.8] nmol/L. Of these, 38.7% had Lp(a) >100 nmol/L. Women had higher Lp(a) than men (p-trend=0.014). Lp(a) levels were similar across traditional cardiovascular risk factors categories. Among patients without traditional cardiovascular risk factors, women also had higher Lp(a) than men (p=0.003). Elevated Lp(a) was associated with a history of coronary artery disease (p-trend=0.003) and with treatment with high-intensity statins alone (p-trend=0.032) or in combination with ezetimibe (p-trend=0.014).
Conclusions: Lp(a) levels showed a heterogeneous distribution and were not associated with traditional cardiovascular risk factors or other lipid parameters. This reinforces Lp(a) as an independent risk factor, supporting active screening in patients with ACS, particularly in women not affected by traditional cardiovascular risk factors.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.