Prevalence of hyperlipoproteinemia(a) in individuals of European ancestry treated at outpatient cardiology clinics: results from a cross-sectional STAR-Lp(a) study.

Abstract

Introduction: Elevated levels of lipoprotein(a) [Lp(a)] are independently associated with an increased risk of cardiovascular disease (CVD).

Objectives: We aimed to evaluate the levels of Lp(a) among patients of European ancestry referred to outpatient cardiology clinics.

Patients and methods: We analyzed 2475 consecutive patients referred to 2 outpatient cardiology clinics between March 2022 and January 2024. Individuals with atherosclerotic CVD, heart failure, significant valve disease, and aortic aneurysm were excluded.

Results: A majority of the study population were women (n = 1724 [69.7%]). The median (interquartile range) age of the participants was 66 (53-73) years. An Lp(a) level greater than or equal to 30 mg/dl (≥75 nmol/l) was recorded in 21.5% and a level greater than or equal to 50 mg/dl (≥125 nmol/l) was recorded in 13.5% of the patients. In univariable analysis, the Lp(a) level was significantly associated with hypertension, sleep apnea, migraine, polycystic ovary syndrome, physical activity level, as well as fasting blood glucose, glycated hemoglobin A1c (HbA1c), low‑density lipoprotein cholesterol (LDL‑C), and non-high‑density lipoprotein cholesterol concentrations. Female sex (β [SE] = 0.06 [0.02]), atrial fibrillation (β [SE] = 0.05 [0.02]), and the levels of HbA1c (β [SE] = 0.14 [0.02]) and LDL‑C (β [SE] = 0.09 [0.02]) were independently related to the level of Lp(a). Atrial fibrillation (odds ratio [OR], 1.8; 95% CI, 1.01-3.19), migraine (OR, 0.51; 95% CI, 0.32-0.83), and hyperlipidemia (OR, 1.56; 95% CI, 1.22-1.99) were related to the Lp(a) level of 30 mg/dl or above (≥75 nmol/l), while female sex (OR, 1.46; 95% CI, 1.10-1.92), hyperlipidemia (OR, 1.49; 95% CI, 1.12-1.97), hypertension (OR, 1.42; 95% CI, 1.1-1.84) and HbA1c concentration (OR, 0.84; 95% CI, 0.72-0.96) were significantly associated with the Lp(a) level greater than or equal to 50 mg/dl (≥125 nmol/l).

Conclusions: The observed prevalence of increased Lp(a) concentration among patients of European ancestry treated at outpatient cardiology clinics was 21.5%. Female sex, hypertension, atrial fibrillation, migraine, and concentrations of LDL‑C and HbA1c were independently related to the level of Lp(a) in this population.