This study looked at the relationship between two substances in the blood, LDL-cholesterol (LDL-C) and lipoprotein(a) (Lp(a)), and their connection to coronary heart disease (CHD). They wanted to see if having high levels of Lp(a) increased the risk of CHD, especially when LDL-C levels were low (≤ 100 mg/dL), and the participants were not using statin therapy.
They studied 4,585 people from different ethnic backgrounds and divided them into four groups based on their LDL-C and Lp(a) levels. They followed these participants for around 13 years and recorded any cases of CHD events that occurred.
The results showed that having high levels of Lp(a) increased the risk of CHD events, regardless of whether the LDL-C levels were low or high. Those with low LDL-C and high Lp(a) had a higher risk of CHD compared to those with low LDL-C and low Lp(a). Similarly, those with high LDL-C and high Lp(a) also had an increased risk.
In conclusion, this study suggests that elevated Lp(a) is an important risk factor for CHD, even when LDL-C levels are well-controlled without statin therapy. People with high Lp(a) may benefit from more aggressive preventive measures to reduce their risk of heart disease.
Source: Rikhi R, Hammoud A, Ashburn N, Snavely AC, Michos ED, Chevli P, Tsai MY, Herrington D, Shapiro MD. Relationship of Low-Density Lipoprotein-Cholesterol and Lipoprotein(a) to Cardiovascular Risk - the Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis. 2022 Dec; 363: 102-108.