Association between elevated lipoprotein(a) levels and vulnerability of carotid atherosclerotic plaque: A systematic review

Background

The role of lipoprotein(a) [Lp(a)] as a potential risk factor for atherosclerotic arterial disease has been extensively studied. However, the available data regarding its association with the vulnerability of carotid atherosclerotic plaque is limited. The main objective of the present systematic review was to assess the association between elevated Lp(a) levels and carotid vulnerable plaque features.

Methods

This systematic review adhered to PRISMA guidelines, conducting a comprehensive literature search to identify studies examining the association between Lp(a) levels and vulnerability of carotid atherosclerotic plaque. Experimental or observational studies were eligible, without language, country, or publication type restrictions.

Results

Nine studies including 2058 patients were eligible for this systematic review. Five cross-sectional studies, 3 prospective/retrospective cohorts, and 1 subanalysis of a randomized controlled trial were analyzed. Two cross-sectional studies that compared Lp(a) levels between patients with and without vulnerable carotid plaque showed discordant results. Nevertheless, all the studies that evaluated the prevalence or incidence of vulnerable carotid plaque according to Lp(a) levels showed a positive association. Similarly, one study found a significant correlation between vulnerability of carotid plaque and Lp(a) levels.

Conclusion

Almost all studies analyzed in the present review showed a positive association between elevated Lp(a) levels and carotid vulnerable plaque features. However, further research is needed to clarify this issue.