Lipoprotein(a) and coronary artery calcium in comparison with other lipid biomarkers: The multi-ethnic study of atherosclerosis - PubMed (original) (raw)

Comparative Study

Lipoprotein(a) and coronary artery calcium in comparison with other lipid biomarkers: The multi-ethnic study of atherosclerosis

Candace L Jackson et al. J Clin Lipidol. 2023 Jul-Aug.

Abstract

Background: Coronary artery calcium (CAC) scoring is often used for atherosclerotic cardiovascular disease (ASCVD) risk stratification in individuals with elevated lipoprotein(a) [Lp(a)].

Objective: To evaluate associations between Lp(a) and baseline CAC (volume/density) and CAC progression compared to other lipid biomarkers.

Methods: We utilized data from the Multi-Ethnic Study of Atherosclerosis (MESA), a cohort study of individuals without clinical ASCVD, excluding statin users. We evaluated the associations between Lp(a), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglycerides, total cholesterol, apolipoprotein B, and non-HDL-C with baseline CAC and annual CAC progression using multivariable ordinal regression with adjustment for ASCVD risk factors. Analyses were also stratified by median age.

Results: In 5,597 participants (2,726 at median 9.5-year follow-up), Lp(a) was not associated with baseline CAC volume or density and was modestly associated with volume progression (OR 1.11, 95% CI 1.03-1.21). However, other biomarkers were positively associated with baseline volume and volume progression (LDL-C: OR 1.26, 95% CI: 1.19-1.33 and OR 1.22, 95% CI: 1.15-1.30, respectively), except HDL-C which was inversely associated. LDL-C, total cholesterol and non-HDL-C were inversely associated with baseline density. In participants <62 years of age, Lp(a) was modestly associated with baseline CAC volume (OR 1.10, 95% CI: 1.00-1.20) and volume progression (OR 1.16 95% CI: 1.04-1.30).

Conclusions: In contrast to other lipid biomarkers, Lp(a) was not associated with baseline CAC volume or density and was only modestly associated with volume progression. Our findings suggest that Lp(a) is not as robustly associated with CAC as other lipid biomarkers.

Keywords: Computed tomography; Coronary artery calcium; Lipids; Lipoprotein(a); Primary prevention.

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Conflict of interest statement

Declarations of Competing Interest: HB received consulting fees from Kaneka Medical America. ST is a co-inventor and receives royalties from patents owned by UCSD and is a co-founder and has an equity interest in Oxitope and Kleanthi Diagnostics, and has a dual appointment at UCSD and Ionis Pharmaceuticals. Although these relationships have been identified for conflict-of-interest management based on the overall scope of the project, the research findings included in this particular publication may not necessarily relate to the interests of the above companies. The terms of this arrangement have been reviewed and approved by the University of California, San Diego in accordance with its conflict-of-interest policies. The other co-authors have nothing to disclose.

Figures

Figure 1

Flow diagram of study population. Abbreviations: CAC, coronary artery calcium; CT, computed tomography; CVD, cardiovascular disease; Lp(a), lipoprotein(a); MESA, Multi-Ethnic Study of Atherosclerosis.

Figure 2

Association between lipid biomarkers and baseline coronary artery calcium (CAC) volume and density. Abbreviations: CAC, coronary artery calcium; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; apoB, apolipoprotein B; Lp(a), lipoprotein (a); TG, triglycerides.

Figure 3

Association between lipid biomarkers and coronary artery calcium (CAC) volume progression. Abbreviations: CAC, coronary artery calcium; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; apoB, apolipoprotein B; Lp(a), lipoprotein (a); TG, triglycerides.

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Lipoprotein(a) and coronary artery calcium in comparison with other lipid biomarkers: The multi-ethnic study of atherosclerosis - PubMed (original) (raw)