Association of Lipoprotein(a) With Atherosclerotic Plaque Progression

Lipoprotein (a) [Lp (a)] is associated with an increased risk of myocardial infarction, although the mechanism for this observation remains uncertain. Objectives A study was conducted to investigate whether Lp(a) is associated with adverse plaque progression. Methods In this study Lp(a) was measured in patients with advanced stable coronary artery disease undergoing coronary CT  angiography at baseline and 12 months to assess progression of total, calcific, noncalcific, and low-attenuation plaque (necrotic core) in particular. High Lp(a) was defined as Lp(a) ≥ 70 mg/dL. The relationship of Lp(a) with plaque progression was assessed using linear regression analysis. Results A total of 191 patients (65.9 ± 8.3 years of age; 152 [80%] male) were included in the analysis, with median Lp(a) values of 100. At baseline, there was no difference in coronary artery disease severity or plaque burden. Patients with high Lp(a) showed accelerated progression compared with low Lp(a) patients (P = 0.020). Multivariable linear regression analysis confirmed the relation between Lp(a) and low-attenuation plaque volume progression (10.5% increase for each 50 mg/dL of Lp(a), 95% CI: 0.7%-20.3%). There was no difference in total, calcific, and non-calcific plaque volume progression. The study thus Concluded that Among patients with advanced stable coronary artery disease, Lp(a) is associated with accelerated progression of coronary low-attenuation plaque (necrotic core). This also explain the association between Lp(a) and the high residual risk of myocardial infarction, providing support for Lp(a) as a treatment target in atherosclerosis. Disclaimer: Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STAR UPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.