The prevalence of hyperlipoproteinemia(a) in outpatient cardiology clinic patients of European ancestry: results from a STAR-Lp(a) cross-sectional study.

Abstract

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

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

Patients and methods: We included 2475 consecutive patients referred to outpatient cardiology clinics between March 2022 and January 2024. We excluded all patients with atherosclerotic cardiovascular disease, heart failure, significant valve disease, and aortic aneurysm.

Results: The median age of the 2475 study participants (of which 1724 [69.7%] were women) was 66.0 years [53.0-73.0 years]). An Lp(a) level of ≥30 mg/dL (≥75 nmol/L) was recorded in 21.5% and a level of ≥50 mg/dL (≥125 nmol/L) was recorded in 13.5% of patients. In univariable analysis the level of Lp(a) was significantly associated with hypertension, sleep apnea, migraine, polycystic ovary syndrome, physical activity, fasting blood glucose, HbA1c, LDL, and non-HDL cholesterol. Being female (β±SE 0.06±0.02), atrial fibrillation (0.05±0.02), HbA1c (0.14±0.02), and LDL cholesterol (0.09±0.02) were independently related to the level of Lp(a). Atrial fibrillation (odds ratio [OR] 1.80, 95%CI:1.01-3.19), migraine (0.51, 0.32-0.83) and hyperlipidemia (1.56, 1.22-1.99) were related to Lp(a) ≥30 mg/dL (≥75 nmol/L), while being female (1.46, 1.10-1.92), hyperlipidemia (1.49, 1.12-1.97), hypertension (1.42, 1.10-1.84) and HbA1c (0.84, 0.72-0.96) were related to Lp(a) ≥50 mg/dL (≥125 nmol/L).

Conclusions: The prevalence of increased Lp(a) concentration among patients of European ancestry consulting with cardiologists is 21.5%. Being female, hypertension, atrial fibrillation, migraine, LDL-C, and HbA1c concentration are independently related to the level of Lp(a) in this population.