Use of Coronary Artery Calcium Scoring in Individuals With Elevated Lipoprotein(a): A Multicohort Study - PubMed
3 hours ago
- #lipoprotein(a)
- #coronary artery calcium
- #ASCVD risk assessment
- The study evaluates the interaction between elevated lipoprotein(a) [Lp(a)] (>50 mg/dL) and coronary artery calcium (CAC) score in assessing atherosclerotic cardiovascular disease (ASCVD) risk.
- A pooled cohort of 11,319 participants without known ASCVD from 4 U.S.-based studies was analyzed over a mean follow-up of 14.8 years, with 1,569 incident ASCVD events.
- Elevated Lp(a) and CAC >0 were independently associated with increased ASCVD risk, with no significant interaction between them (P interaction = 0.80).
- Among individuals with CAC = 0, ASCVD incidence rates were low but higher in those with Lp(a) >50 mg/dL compared to ≤50 mg/dL (4.9 vs 3.8/1,000 person-years).
- For those with CAC >0, elevated Lp(a) was associated with higher ASCVD risk (21.2 vs 18.2/1,000 person-years).
- The highest risk was observed in individuals with both CAC ≥300 and Lp(a) >50 mg/dL (HR: 6.12; 95% CI: 4.80-7.81).
- Results were consistent across age and sex, with greater absolute risk in individuals >50 years and men.
- CAC scoring remains a valuable tool for ASCVD risk assessment in individuals with elevated Lp(a), even though absolute event rates remain low in those with CAC = 0.