The association of lipoprotein(a) and coronary artery calcium in asymptomatic patients: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#humans #female #middle-aged #male #calcium

The association of lipoprotein(a) and coronary artery calcium in asymptomatic patients: a systematic review and meta-analysis

Martignoni et al., 2024 | Eur J Prev Cardiol | Meta Analysis

Citation

Martignoni Felipe Villa, Rl Júnior José Eduardo, ... Miedema Michael. The association of lipoprotein(a) and coronary artery calcium in asymptomatic patients: a systematic review and meta-analysis. Eur J Prev Cardiol. 2024-Apr-18;31(6):732-741. doi:10.1093/eurjpc/zwae043

Abstract

AIMS: Lipoprotein(a) [Lp(a)] is an atherogenic lipid particle associated with increased risk for coronary heart disease (CHD) events. Coronary artery calcium (CAC) score is a tool to diagnose subclinical atherosclerosis and guide clinical decision-making for primary prevention of CHD. Studies show conflicting results concerning the relationship between Lp(a) and CAC in asymptomatic populations. We conducted a meta-analysis to evaluate the association of Lp(a) and CAC in asymptomatic patients. METHODS AND RESULTS: We systematically searched PubMed, Embase, and Cochrane until April 2023 for studies evaluating the association between Lp(a) and CAC in asymptomatic patients. We evaluated CAC > 0 Agatston units, and CAC ≥ 100. Lp(a) was analysed as a continuous or dichotomous variable. We assessed the association between Lp(a) and CAC with pooled odds ratios (OR) adopting a random-effects model. A total of 23 105 patients from 18 studies were included in the meta-analysis with a mean age of 55.9 years, 46.4% female. Elevated Lp(a) increased the odds of CAC > 0 [OR 1.31; 95% confidence intervals (CI) 1.05-1.64; P = 0.02], CAC ≥100 (OR 1.29; 95% CI 1.01-1.65; P = 0.04; ), and CAC progression (OR 1.43; 95% CI 1.20-1.70; P < 0.01; ). For each increment of 1 mg/dL in Lp(a) there was a 1% in the odds of CAC > 0 (OR 1.01; 95% CI 1.01-1.01; P < 0.01). CONCLUSION: Our findings of this meta-analysis suggest that Lp(a) is positively associated with a higher likelihood of CAC. Higher Lp(a) levels increased the odds of CAC >0. These data support the concept that Lp(a) is atherogenic, although with high heterogeneity and a low level of certainty. PROTOCOL REGISTRATION: CRD42023422034. KEY FINDINGS: Asymptomatic patients with elevated Lp(a) had 31% higher chances of having any coronary calcification (CAC > 0) and 29% higher chances of having more advanced calcification (CAC > 100). It increased the chances of having progression of coronary calcification over time by 43%. For each 1 mg/dL of Lp(a) there was an increment of 1% chance of having coronary calcification.

Key Findings

We systematically searched PubMed, Embase, and Cochrane until April 2023 for studies evaluating the association between Lp(a) and CAC in asymptomatic patients. We evaluated CAC > 0 Agatston units, and CAC ≥ 100. Lp(a) was analysed as a continuous or dichotomous variable. We assessed the association between Lp(a) and CAC with pooled odds ratios (OR) adopting a random-effects model. A total of 23 105 patients from 18 studies were included in the meta-analysis with a mean age of 55.9 years, 46.4% f

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population elevated lp
Sample Size 105
Age Range mean age of 55.9
Condition See abstract

MeSH Terms

  • Humans
  • Female
  • Middle Aged
  • Male
  • Calcium
  • Coronary Artery Disease
  • Risk Factors
  • Coronary Vessels
  • Lipoprotein(a)
  • Atherosclerosis
  • Calcinosis
  • Vascular Calcification

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Meta-Analysis, Systematic Review, Journal Article
  • Vertical: calcium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09