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Prevalence of high lipoprotein (a) levels in patients with premature myocardial infarction: systematic review
Session:
SESSÃO DE POSTERS 07 - DOENÇAS CARDIOVASCULARES - LESÃO RENAL AGUDA E INFLAMAÇÃO
Speaker:
Mariana de Almeida Agapito Fonseca
Congress:
CPC 2025
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.6 Acute Coronary Syndromes - Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
Mariana Agapito Fonseca; Francisco Salvaterra; Mariana Alves; Daniel Caldeira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong><span style="font-family:"Calibri",sans-serif">INTRODUCTION</span></strong><br /> <span style="font-family:"Calibri",sans-serif">Young patients with acute myocardial infarction (MI) represent a unique population, often lacking the traditional cardiovascular risk factors typically present in older individuals. In this group, genetic factors, such as elevated lipoprotein(a) [Lp(a)] levels, may play a pivotal role in the development of premature atherosclerotic cardiovascular disease (ASCVD). Elevated Lp(a) exerts proatherogenic, prothrombotic and proinflammatory effects, accelerating the progression of ASCVD. While studies trying to address the relevance of Lp(a) are undergoing, it is very important to acknowledge the dimension of the contribution of Lp(a) in this population.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong><span style="font-family:"Calibri",sans-serif">OBJECTIVE</span></strong><br /> <span style="font-family:"Calibri",sans-serif">This systematic review aims to estimate the prevalence of elevated Lp(a) levels in patients with premature MI.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong><span style="font-family:"Calibri",sans-serif">METHODS</span></strong><br /> <span style="font-family:"Calibri",sans-serif">A systematic search was conducted in PubMed/MEDLINE and Cochrane CENTRAL, complemented by manual reference checks. The review included all types of studies (interventional and observational, cross-sectional or longitudinal, including randomized controlled trials, cohort, case-control and cross-sectional studies) that provided data about the proportion of patients with premature MI, defined as under 55 years old in men and under 65 years old in women, and elevated Lp(a). The outcome of interest was the prevalence of elevated Lp(a) levels. A <span style="background-color:white">random effects meta-analysis was performed to derive pooled estimates of frequency and corresponding 95% confidence intervals.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong><span style="font-family:"Calibri",sans-serif">RESULTS</span></strong><br /> <span style="font-family:"Calibri",sans-serif">352 studies were screened and 13 studies fulfilled the inclusion criteria. These studies enrolled a total of 2841 premature MI patients. Three different cut-off values were identified for elevated Lp(a): 20 mg/dL (n=1), 30 mg/dL (n=11) and 50 mg/dL (n=1). Overall, 39,09% (95% CI 30,10-48,46) of premature MI patients had elevated Lp(a). Specifically, at the 20 mg/dL cut-off, 70% of patients had elevated Lp(a), which decreased to 39% at the 30 mg/dL cut-off and further dropped to 16% at the 50 mg/dL cut-off.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong><span style="font-family:"Calibri",sans-serif">CONCLUSION</span></strong><br /> <span style="font-family:"Calibri",sans-serif">This systematic review revealed that the prevalence of elevated Lp(a) in young patients with MI was around 40%. These findings suggest that elevated Lp(a) may significantly contribute to premature cardiovascular events. </span></span></span></p>
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