ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1541712
This article is part of the Research TopicScreening Remnant Lipid Markers in Cardiometabolic DiseasesView all 13 articles
Lipoprotein(a) as a predictor of mortality in hospitalised patients with ischaemic heart disease
Provisionally accepted
Wann Jia Loh1*
Xuan Han Koh1
Colin Yeo1
Ruan Xu Cong1
Siang Chew CHAI1
TarChoon Aw1Chew Kiat Heng2Roger Foo2- 1Changi General Hospital, Singapore, Singapore
- 2National University of Singapore, Singapore, Singapore
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Elevated Lipoprotein(a) [Lp(a)] increases the risk of cardiovascular disease and mortality in population studies but reports of whether elevated Lp(a) concentration predicts mortality in hospitalised patients with cardiovascular disease are still lacking and conflicting.Aim: To investigate whether elevated Lp(a) predicted cardiovascular outcomes in patients with ischaemic heart disease (IHD) admitted to hospital.Methods: Serum Lp(a) concentrations were measured in 520 consecutively recruited patients admitted to hospital with IHD, half of whom had an acute myocardial infarction. Patients with elevated Lp(a) at baseline were compared with patients with non-elevated Lp(a). In this observational prospective cohort study, multivariable Cox proportional hazards regression was used to assess the association of baseline Lp(a) with hazard rates (HR) of mortality and major adverse cardiovascular events (MACE).Results: During the 2-year follow-up period, 14.6%, 8.5%, and 49.2% of patients had all-cause mortality, cardiovascular mortality, and MACE respectively. Median age was 63.5 years, 82.3% were male and the median Lp(a) was 35.2 nmol/L. Multivariable Cox regression showed baseline Lp(a) ≥70 nmol/L was associated with increased risk of all-cause mortality , p=0.007) and cardiovascular mortality (HR 2.01 [1.06-3.82], p=0.033), but was not statistically significant for MACE ], p=0.067). Higher natural log-transformed Lp(a) concentrations predicted all-cause mortality ], p=0.042) but not for cardiovascular mortality or MACE.In a multi-ethnic Asian patient cohort, elevated Lp(a) concentrations ≥70 nmol/L at hospitalization positively predicted cardiovascular and all-cause mortality in patients with ischaemic heart disease. Our findings support guidelines' recommendation for routine evaluation of Lp(a) in all patients at high cardiovascular risk.
Keywords: Lipoprotein(a), Lp(a), Coronary Artery Disease, ischaemic heart disease, asian, ethnicity, cardiovascular, Atherosclerosis
Received: 08 Dec 2024; Accepted: 07 Jul 2025.
Copyright: © 2025 Loh, Koh, Yeo, Cong, CHAI, Aw, Heng and Foo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wann Jia Loh, Changi General Hospital, Singapore, Singapore
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