New Family Heart study: Increased lipoprotein(a) levels continuously increase risk for recurrent cardiovascular events

The Family Heart Foundation has published groundbreaking results from the largest study ever conducted on individuals living with cardiovascular disease and measured lipoprotein(a) [Lp(a)]. The study reveals that increases in levels of Lp(a) are associated with a higher risk of cardiovascular events, including heart attack and stroke. These findings were presented on May 7th at the European Atherosclerosis Society (EAS) Congress in Glasgow, Scotland, by Dr. Børge Nordestgaard, President of EAS, and simultaneously published in the peer-reviewed European Heart Journal, Lipoprotein(a) and recurrent atherosclerotic cardiovascular events: the US Family Heart Database.

 

“The results are crystal clear; in patients who already have experienced cardiovascular events, higher Lp(a) levels drive a higher risk of new events in a continuous manner, irrespective of sex, ethnicity or race. Intriguingly, we observed that this risk appears to be mitigated in patients receiving high-impact LDL cholesterol-lowering therapy.”

– Professor Børge Nordestgaard
President, European Atherosclerosis Society (EAS)

• Continuous Increase in Risk: Unlike previous studies, this research shows that the risk of recurring cardiovascular events for those with atherosclerotic cardiovascular disease (ASCVD) continues to rise across all ascending levels of Lp(a), with no indication of risk plateauing.

• Study Population: The study followed 273,770 US individuals with ASCVD for a median of 5.4 years, tracking cardiovascular events such as myocardial infarction, ischemic stroke, percutaneous coronary intervention, or coronary artery bypass graft. Population highlights include:
  • • 43% women (117,000)
    • 8% Black individuals (22,000)
    • Average age: 64 years
    • Regional distribution: 10% Midwest, 20% Northeast, 46% South, 20% West, 4% Unknown
    • 75% also had hypertension; 33% also had diabetes
• Lp(a) Levels: Participants were categorized into five groups based on Lp(a) levels: low (<15 nmol/L), moderate (15-79 nmol/L), moderate-to-high (80-179 nmol/L), high (180-299 nmol/L), and very high (≥300 nmol/L).
• Impact on Different Demographics: Average Lp(a) levels are higher in women compared to men. Black individuals have substantially higher average Lp(a) levels than other racial/ethnic groups.

“Among the many important findings in this study, we now know that in people living with cardiovascular disease every nmol/L of Lp(a) confers increased risk of a subsequent cardiovascular event.  This is a meaningful advancement in our understanding of the impact of Lp(a) on one’s health,”

– Diane MacDougall
Vice President of Research, Family Heart Foundation

Significant insights

• Risk Confirmation: Individuals with the highest Lp(a) levels (≥ 300 nmol/L) were about 40% more likely to experience a cardiovascular event within five years compared to those with the lowest levels (<15 nmol/L).
• Consistent Risk Increase: The study confirms that the risk of subsequent cardiovascular events rises consistently with increasing Lp(a) levels, regardless of the type of cardiovascular disease, diabetes status, sex, or race/ethnicity.

Click to view infographic

“While previous smaller studies have shown that the risk of cardiovascular events can increase within certain ranges of Lp(a), this is the first study to show that the risks of cardiovascular events including heart attack, stroke and cardiac surgeries continue to increase across all ascending levels of Lp(a) and that there is no indication that the risk plateaus. The US has lagged behind many other countries in recommending that adults complete a simple blood test to measure Lp(a). This study strongly confirms the importance of considering Lp(a) levels among other risk factors when determining an individual’s risk of future heart attacks and strokes.”

– Katherine Wilemon
Founder & CEO, Family Heart Foundation

Why this is important