Abstract
Background
High lipoprotein(a) [Lp(a)] levels have been re-evaluated as an independent risk factor
for atherosclerotic vascular diseases.
Methods
We assessed whether serum Lp(a) levels can significantly influence long-term survival
in subjects with an equal general cardiovascular (CV) risk profile.
We prospectively evaluated a sample of 1215 adult subjects from the Brisighella Heart
Study cohort (M: 608; F: 607; aged 40–69) who had no cardiovascular disease at enrolment.
According to the CUORE project risk-charts (Italian-specific risk-charts), individuals
were stratified into a low—(n = 865), an intermediate—(n = 275) and a high—(n = 75) cardiovascular risk groups. Kaplan–Meier 25-year survival analysis was carried
out examining apart each class of risk and the log-rank statistic was used to estimate,
when statistically possible, the survival time of the subjects stratified into quartiles
of Lp(a).
Results
Subjects at high and intermediate CV risk aged 56–69 years (regardless of gender) and women aged 40–55 years with a low CV risk profile who had lower Lp(a) levels showed a significant benefit
on CV mortality (P < 0.05 always) and, indicatively, on the estimated survival time (even P < 0.05). The ROC curves constructing for each CV risk group using Lp(a) as test-variable
and death as state-variable identified serum Lp(a) as an independent long-term CV
mortality prognosticator for subjects at high CV risk (AUC = 0.63, 95%CI [0.50–0.76], P = 0.049) and women with an intermediate CV risk profile (AUC = 0.7, 95%CI [0.52–0.79], P = 0.034).
Conclusions
In the light of our finding and at the best of the previous knowledge, dosing Lp(a)
is confirmed as important in subjects at high or medium risk (even if in primary prevention
for CV diseases), especially in women.
Keywords
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Article info
Publication history
Published online: August 20, 2016
Accepted:
August 10,
2016
Received:
July 17,
2016
Identification
Copyright
© 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
