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Determinants of lipoprotein(a) fluctuation in outpatient settings: insights from a single-center cohort
Session:
Sessão de Posters 07 - Lípidos para além do LDL: a nova fronteira do risco
Speaker:
Marta Catarina Almeida
Congress:
CPC 2026
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.1 Risk Factors and Prevention – Epidemiology
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Marta Catarina Ferreira de Almeida; André Lobo; Carolina Marques Neves; Eduardo Vilela; Ricardo Fontes-Carvalho
Abstract
<p style="margin-left:47px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Background: </strong>Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular (CV) disease, considered to be mostly genetically determined, but data on fluctuations in recent placebo groups in clinical trials challenged this concept of stability.</span></span></p> <p style="margin-left:47px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Purpose: </strong>The aim of this study was to evaluate Lp(a) levels variability in patients who measured Lp(a) in stable settings as outpatients and identify its predictors.</span></span></p> <p style="margin-left:47px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Methods: </strong>A retrospective single-center analysis of Lp(a) levels collect in a stable setting, as outpatients, was conducted. Demographics, cardiovascular risk factors, comorbidities and medication use were registered. Context of measurement, time intervals and laboratory parameters with lipid profile were collected. Relevant Lp(a) variability was defined as an absolute change ≥ 50 nmol/L or a relative change ≥ 25%, calculated as [(highest value – lowest value) / lowest value] * 100. Statistical analysis was done using Chi-square, Mann-Whitney tests and logistic regression.</span></span></p> <p style="margin-left:47px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Results:</strong> A total of 45 patients were analyzed. Absolute Lp(a) values range from 2.4 to 463.9 nmol/L in the first measurement and 2.6 to 449.9 nmol/L in the second measurement. Time interval between both measurements was 168 [154] days. Lp(a) variability ranged from -168.3 to + 172.6 nmol/L, with a median absolute variation of 16.0 [64.4] nmol/L and 32.6 [62.7] %. Relevant variation was verified in 26 (57.8%) patients, with the distribution represented in Graph 1. Relevant variation was lower in patients with obesity (OR = 0.486, p = 0.014) and higher in patients with hypertension (OR = 16.500, p <0.001), dyslipidemia (OR = 8.727, p = 0.010) and heart failure (OR = 7.563, p = 0.004). Logistic regression predicted Lp(a) relevant variation (R<sup>2 </sup>= 0.595, p <0.001) and only hypertension remained significant in the multivariate analysis (OR = 7.604, p = 0.040).</span></span></p> <p style="margin-left:47px; text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion: </strong>Lp(a) levels demonstrated notable intra-individual variability of Lp(a) levels measured in stable clinical settings, with more than half of participants with relevant changes. Obesity was associated with lower variability, whereas hypertension, dyslipidemia, and heart failure were linked to higher Lp(a) fluctuations. Hypertension emerged as the only independent predictor in multivariate analysis, explaining almost 60% of the Lp(a) variability in stable settings. These findings challenge the concept of Lp(a) as independent CV risk factor and underscores the importance of further studies on the correlation between hypertension and Lp(a) variability.</span></span></p>
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