The Association of Lipoprotein(a) and Coronary Artery Calcium in Asymptomatic Patients: A Systematic Review and Meta-analysis
Abstract
AIMS
Lipoprotein(a) [Lp(a)] is an atherogenic lipid particle associated with increased risk for coronary heart disease (CHD) events. Coronary artery calcium (CAC) score is a tool to diagnose subclinical atherosclerosis and guide clinical decision-making for primary prevention of CHD. Studies show conflicting results concerning the relationship between Lp(a) and CAC in asymptomatic populations. We conducted a meta-analysis to evaluate the association of Lp(a) and CAC in asymptomatic patients.
METHODS
We systematically searched PubMed, Embase, and Cochrane until April 2023 for studies evaluating the association between Lp(a) and CAC in asymptomatic patients. We evaluated CAC>0 Agatston units, and CAC>100. Lp(a) was analysed as a continuous or dichotomous variable. We assessed the association between Lp(a) and CAC with pooled odds ratios (OR) adopting a random-effects model.
RESULTS
A total of 23,105 patients from 18 studies were included in the meta-analysis with a mean age of 55.9 years, 46.4% female. Elevated Lp(a) increased the odds of CAC>0 (OR 1.31; 95% CI 1.05 to 1.64; p=0.02), CAC ≥100 (OR 1.29; 95% CI 1.01 to 1.65; p=0.04; ), and CAC progression (OR 1.43; 95% CI 1.20 to 1.70; p0 (OR 1.01; 95% CI 1.01 to 1.01; p<0.01).
CONCLUSIONS
Our findings of this meta-analysis suggest that Lp(a) is positively associated with a higher likelihood of CAC. Higher Lp(a) levels increased the odds of CAC >0. These data support the concept that Lp(a) is atherogenic, although with high…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 23,105 participants or records.
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