Lp(a) (Lipoprotein[a]) Concentrations and Incident Atherosclerotic Cardiovascular Disease: New Insights From a Large National Biobank
Patel AP, Wang (汪敏先) M, Pirruccello JP, Ellinor PT, Ng K, Kathiresan S, Khera AV
Arteriosclerosis, thrombosis, and vascular biology · 487 citas
Cómo se estudió
- Diseño
- Estudio de cohortes (clasificado por nuestro filtro de IA)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Organización sin fines de lucro
- American Heart Association
- Universidad u hospital
- Massachusetts General Hospital
- Universidad u hospital
- Broad Institute
- Organización sin fines de lucro
- Fondation Leducq
- Gobierno
- Medical Research Council
- Gobierno
- National Heart, Lung, and Blood Institute
- Gobierno
- National Human Genome Research Institute
- Gobierno
- NHLBI NIH HHS
- Gobierno
- NHGRI NIH HHS
- Subvenciones
- National Heart, Lung, and Blood Institute (T32 HL 007208); National Heart, Lung, and Blood Institute (1RO1HL092577); Fondation Leducq (K24HL105780); National Human Genome Research Institute (K08HG010155); Fondation Leducq (18SFRN34110082); National Heart, Lung, and Blood Institute (K24 HL105780); American Heart Association (R01 HL128914); National Heart, Lung, and Blood Institute (R01HL128914); National Heart, Lung, and Blood Institute (R01 HL092577); Medical Research Council (MC_PC_17228); American Heart Association (18SFRN34110082); Fondation Leducq (1RO1HL092577); Fondation Leducq (T32HL007208); National Human Genome Research Institute (18SFRN34110082); Fondation Leducq (14CVD01); Fondation Leducq (R01HL128914)
Según 9 financiadores declarados.
Publicación
- Publicado
- 2020-10-29 · Arterioscler Thromb Vasc Biol · vol. 41 · número 1 · págs. 465–474
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 563 citas · más que el 100% de estudios similares · 35.9× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 50 trabajos
- Acceso
- Acceso abierto (revista híbrida) · OTHER-OA
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Atherosclerosis and Cardiovascular Diseases · Diabetes, Cardiovascular Risks, and Lipoproteins
- Palabras clave
- lipoprotein(a), atherosclerotic cardiovascular disease, incident cardiovascular events, racial differences, risk gradient, primary prevention, secondary prevention, middle-aged adults, UK Biobank
- MeSH
- humans, lipoprotein(a), prognosis, incidence, risk assessment, primary prevention, time factors, adult, aged, middle aged, biological specimen banks, female, male, atherosclerosis, secondary prevention, biomarkers, united kingdom, race factors, heart disease risk factors
7 autores
- Aniruddh P. Patel🇺🇸Broad Institute; Harvard University; Massachusetts General Hospital; Massachusetts Institute of Technology
- Minxian Wang🇺🇸Broad Institute; Harvard University; Massachusetts Institute of Technology
- James P. Pirruccello🇺🇸Broad Institute; Harvard University; Massachusetts General Hospital; Massachusetts Institute of Technology
- Patrick T. Ellinor🇺🇸Broad Institute; Harvard University; Massachusetts General Hospital; Massachusetts Institute of Technology
- Kenney Ng🇺🇸IBM (United States)
- Sekar Kathiresan🇺🇸Broad Institute; Harvard University; Massachusetts General Hospital; Verve Therapeutics (United States); Massachusetts Institute of Technology
- Amit V. Khera🇺🇸 · autor de correspondenciaBroad Institute; Harvard University; Massachusetts General Hospital; Massachusetts Institute of Technology
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
Lp(a) (lipoprotein[a]) concentrations are associated with atherosclerotic cardiovascular disease (ASCVD), and new therapies that enable potent and specific reduction are in development. In the largest study conducted to date, we address 3 areas of uncertainty: (1) the magnitude and shape of ASCVD risk conferred across the distribution of lipoprotein(a) concentrations; (2) variation of risk across racial and clinical subgroups; (3) clinical importance of a high lipoprotein(a) threshold to guide therapy. Approach and Results: Relationship of lipoprotein(a) to incident ASCVD was studied in 460 506 middle-aged UK Biobank participants. Over a median follow-up of 11.2 years, incident ASCVD occurred in 22 401 (4.9%) participants. Median lipoprotein(a) concentration was 19.6 nmol/L (25th-75th percentile 7.6-74.8). The relationship between lipoprotein(a) and ASCVD appeared linear across the distribution, with a hazard ratio of 1.11 (95% CI, 1.10-1.12) per 50 nmol/L increment. Substantial differences in concentrations were noted according to race-median values for white, South Asian, black, and Chinese individuals were 19, 31, 75, and 16 nmol/L, respectively. However, risk per 50 nmol/L appeared similar-hazard ratios of 1.11, 1.10, and 1.07 for white, South Asian, and black individuals, respectively. A high lipoprotein(a) concentration defined as ≥150 nmol/L was present in 12.2% of those without and 20.3% of those with preexisting ASCVD and associated with hazard ratios of 1.50 (95% CI, 1.44-1.56) and 1.16 (95% CI, 1.05-1.27), respectively.
Conclusions
Lipoprotein(a) concentrations predict incident ASCVD among middle-aged adults within primary and secondary prevention contexts, with a linear risk gradient across the distribution. Concentrations are variable across racial subgroups, but the associated risk appears similar.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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