Physicians' Academy for Cardiovascular Education

Lp(a) is not associated with thrombotic events

News - May 25, 2022

Lipoprotein(a) does not have a clinically significant arterial or venous prothrombotic effect

Presented at EAS 2022 by Elena Olmastroni (Milan, Italy)

Introduction and methods

Epidemiological meta-analysis, mendelian randomization and genome-wide association studies have demonstrated that lipoprotein(a) [Lp(a)] is an independent and causal contributor to ASCVD events. On the other hand, studies investigating a possible link between Lp(a) and VTE have reported conflicting results. The current study aimed to clarify the relation between Lp(a) and VTE by investigating whether Lp(a) has genetically and clinically meaningful venous or arterial prothrombotic effects.

The study used data from 445,774 participants (mean age 57.3 years, 54% female) from the UK Biobank. Exposure to Lp(a) was characterized from a clinical point of view by a measurement at the time of enrolment in the UK Biobank, and from a genetical point of view as an additive genetic score including two genetic variants.

Outcomes were major coronary events (MCE, defined as first occurrence of fatal or non-fatal MI, or coronary revascularization) and VTE (defined as a composite of DVT and PE). Stratified analyses were performed where the association between Lp(a) and MCE was stratified by genetic scores that mimic the effect of antiplatelet and antithrombin therapies.

Main results

Conclusion

This study found that Lp(a) concentrations are not associated with thrombotic events. Elena Olmastroni further concluded that the increased risk of MCE caused by elevated Lp(a) is unlikely to be decreased by antiplatelet or antithrombin therapy. Therapies specially aimed at lowering Lp(a) are therefore needed.

– Our coverage of EAS 2022 is based on the information provided during the congress –

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