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Lipoprotein(a) and Acute Coronary Syndrome: Associations with Sex, Age and Traditional Cardiovascular Risk Factors
Session:
SESSÃO DE POSTERS 36 - TUDO SOBRE LÍPIDOS
Speaker:
Catarina Carrapa
Congress:
CPC 2025
Topic:
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Theme:
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Subtheme:
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Session Type:
Cartazes
FP Number:
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Authors:
Catarina Carrapa; Marta Leite; Francisca Saraiva; Sílvia O. Diaz; Inês Neves; Marta Almeida; Eduardo Vilela; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong>Background: </strong>Lipoprotein(a) [Lp(a)] is an independent risk factor for coronary disease due to its atherogenic, proinflammatory, and prothrombotic properties. Current guidelines recommend a single measurement in adults to refine the risk of acute coronary events.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong>Aim: </strong>We aim to characterize Lp(a) levels in patients presenting with acute coronary syndrome (ACS) and explore associations with sex, age, comorbidities, and traditional cardiovascular risk factors (TCVRF).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong>Methods:</strong> We included all patients admitted with ACS from January 2022 to December 2023 in our center who had Lp(a) levels measured at admission. Patients were stratified into two groups based on Lp(a) levels: elevated (>100 nmol/L) vs. normal (≤100 nmol/L). Premature coronary disease was defined as occurring in men aged ≤55 years and women aged ≤60 years. Demographic and clinical data, including TCVRF (dyslipidemia, diabetes, hypertension, smoking, and obesity), were collected from hospital records. Chi-square and independent t or Mann-Whitney tests were used to compare categorical and quantitative variables between groups, respectively.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong>Results: </strong>A total of 388 patients were included in our analysis: 238 (61.3%) with normal Lp(a) levels and 150 (38.7%) with high Lp(a) levels. The cohort comprised 19.6% women and 80.4% men, with a median age of 63 years (IQR 55–73); 32.5% had premature coronary disease. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif">Women tended to have higher Lp(a) levels [47% of women had high Lp(a) vs. 37% of men with high Lp(a)] although not significant (p=0.082). There were no significant differences in age distribution (p=0.4). [Figure 1]</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif">There were no significant differences in comorbidities, event characteristics, or complications between groups. A higher percentage of patients in the high Lp(a) group were treated with ezetimibe (14% vs. 8.4%; p=0.081). No correlation was found between Lp(a) and LDL-c, HDL-c, total cholesterol, or triglycerides (p=0.312, 0.514, 0.208, 0.162, respectively).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif">Overall, 10.7% of patients had no TCVRF, while 89.3% had at least one. Lp(a) levels did not differ significantly across TCVRF categories, and no specific risk factor was associated with elevated Lp(a). Among patients without TCVRF, women had higher Lp(a) levels than men. In those with ≥1 TCVRF, older women exhibited a tendency for higher Lp(a) levels.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong>Conclusions: </strong>Lp(a) levels show heterogeneous distribution with no significant associations with TCVRF, age, lipid parameters, or other comorbidities, However, a trend indicating higher Lp(a) levels in women presenting with ACS compared to men was noted. These findings highlight Lp(a) as an independent cardiovascular risk factor and underscore the need for larger, more comprehensive studies to explore the potential relation between Lp(a) levels and sex. </span></span></p>
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