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Lipoprotein(a) [Lp(a)] has emerged as a potential risk indicator for major adverse cardiovascular events (MACE).
Raised lipoprotein (a) levels are linked with a higher risk of MACE in atherosclerotic patients, with a stronger link observed in those with T2DM, highlighting the need for interventions targeting both lipoprotein (a) levels and glycemic control.
Lipoprotein(a) [Lp(a)] has emerged as a potential risk indicator for major adverse cardiovascular events (MACE). However, the evidence linking Lp(a) levels with MACE risk in patients with atherosclerosis is still limited, especially in relation to the additional impact of type 2 diabetes mellitus (T2DM). This retrospective cohort study aimed to examine the connection between Lp(a) levels and MACE in atherosclerotic patients and to compare the strength of this association between those with and without T2DM.
This study analyzed atherosclerotic sufferers with and without T2DM who were screened for Lp(a) levels. MACE risk was determined based on Lp(a) levels, categorized into quintiles, and the strength of the Lp(a)-MACE association was compared between T2DM and non-T2DM patients using a partial likelihood ratio test.
Overall, 25,826 patients with established atherosclerotic cardiovascular disease were included, 7,535 of whom had T2DM (29.2%) and 18,291 did not have T2DM (70.8%). Over 160,174 person-years of follow-up, 4,836 MACE events occurred. As opposed to the lowest quintile (Q) of Lp(a) levels, the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for MACE in the higher quintiles were: 1.10 (95% CI: 0.94–1.30), 0.98 (95% CI: 0.83–1.16), 1.25 (95% CI: 1.06–1.46), and 1.29 (95% CI: 1.10–1.51) in T2DM sufferers, and 0.99 (95% CI: 0.88–1.12), 1.10 (95% CI: 0.98–1.23), 1.01 (95% CI: 0.90–1.13), and 1.13 (95% CI: 1.01–1.27) in those without T2DM. The connection between Lp(a) and MACE was stronger in T2DM patients.
In atherosclerotic patients, both with and without T2DM, elevated Lp(a) levels were linked with a heightened risk of MACE. This association was more pronounced in those with T2DM, suggesting that clinical management of both Lp(a) levels and glycemic control is essential for minimizing MACE risk in these patients.
European Journal of Preventive Cardiology
Impact of diabetes on risk of major adverse cardiovascular events associated with lipoprotein(a) levels in patients with established atherosclerotic cardiovascular disease
Kyuwoong Kim et al.
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