Sex Differences in the Association Between Lipoprotein(a) and Cardiovascular Outcomes: The MGB Lp(a) Registry
Background Sex‐based differences in the association of lipoprotein(a) with cardiovascular outcomes have not been well established for those without prior atherosclerotic cardiovascular disease. Methods and Results Patients with no baseline atherosclerotic cardiovascular disease were identified in th...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-05-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.035353 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850131969582563328 |
|---|---|
| author | Gurleen Kaur Adam N. Berman David W. Biery Stephanie A. Besser Wanda Y. Wu Brittany Weber Michael C. Honigberg Khurram Nasir Martha Gulati Marcelo F. Di Carli Leslee J. Shaw Deepak L. Bhatt Ron Blankstein |
| author_facet | Gurleen Kaur Adam N. Berman David W. Biery Stephanie A. Besser Wanda Y. Wu Brittany Weber Michael C. Honigberg Khurram Nasir Martha Gulati Marcelo F. Di Carli Leslee J. Shaw Deepak L. Bhatt Ron Blankstein |
| author_sort | Gurleen Kaur |
| collection | DOAJ |
| description | Background Sex‐based differences in the association of lipoprotein(a) with cardiovascular outcomes have not been well established for those without prior atherosclerotic cardiovascular disease. Methods and Results Patients with no baseline atherosclerotic cardiovascular disease were identified in the MGB (Mass General Brigham) Lp(a) Registry, a retrospective cohort of patients who had lipoprotein(a) measured from 2000 to 2019. Lipoprotein(a) percentile groups were categorized as 1st to 50th (reference), 51st to 70th, 71st to 90th, and 91st to 100th. The primary outcome was a composite of fatal or nonfatal myocardial infarction, or fatal or nonfatal ischemic stroke. Cox proportional hazard modeling was used to assess the association of lipoprotein(a) with the primary outcome. Among 6238 patients with no baseline atherosclerotic cardiovascular disease, 45% were women. Women had higher total cholesterol, low‐density lipoprotein cholesterol, and median lipoprotein(a) (33.2 versus 28.9 nmol/L; P<0.001), whereas men had higher rates of diabetes and atrial fibrillation. Higher lipoprotein(a) was associated with an increased incidence of the primary composite outcome, with patients in the 91st to 100th percentile group (≥216 nmol/L) having an adjusted hazard ratio (HR) of 2.07 (95% CI, 1.31–3.25; P<0.01) in women and 2.39 (95% CI, 1.57–3.65; P<0.01) in men, with no interaction based on sex. When examining individual outcomes, the strongest association was present between lipoprotein(a) and fatal or nonfatal myocardial infarction (women: adjusted HR, 2.61 [95% CI, 1.48–4.61]; men: adjusted HR, 3.36 [95% CI, 2.01–5.60]). When stratifying by age, female sex was associated with a lower risk of fatal or nonfatal myocardial infarction in those aged <60 years; however, among older individuals, the risk conferred by elevated lipoprotein(a) was similar between men and women. Conclusions Among individuals with no prior atherosclerotic cardiovascular disease, elevated lipoprotein(a) is associated with higher rates of cardiovascular outcomes, particularly myocardial infarction, in both women and men. |
| format | Article |
| id | doaj-art-ee043e10649f440a81fa341cd12c4eb7 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-ee043e10649f440a81fa341cd12c4eb72025-08-20T02:32:19ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-05-0114910.1161/JAHA.124.035353Sex Differences in the Association Between Lipoprotein(a) and Cardiovascular Outcomes: The MGB Lp(a) RegistryGurleen Kaur0Adam N. Berman1David W. Biery2Stephanie A. Besser3Wanda Y. Wu4Brittany Weber5Michael C. Honigberg6Khurram Nasir7Martha Gulati8Marcelo F. Di Carli9Leslee J. Shaw10Deepak L. Bhatt11Ron Blankstein12Department of Medicine, Brigham and Women’s Hospital Harvard Medical School Boston MADivision of Cardiovascular Medicine, Brigham and Women’s Hospital Harvard Medical School Boston MADivision of Cardiovascular Medicine, Brigham and Women’s Hospital Harvard Medical School Boston MADivision of Cardiovascular Medicine, Brigham and Women’s Hospital Harvard Medical School Boston MADepartment of Medicine Beth Israel Deaconess Medical Center Boston MADivision of Cardiovascular Medicine, Brigham and Women’s Hospital Harvard Medical School Boston MADivision of Cardiology, Massachusetts General Hospital Harvard Medical School Boston MADivision of Cardiovascular Prevention and Wellness, Department of Cardiovascular Medicine Houston Methodist DeBakey Heart and Vascular Center Houston TXBarbra Streisand Women’s Heart Center, Smidt Heart Institute, Department of Cardiology Cedars‐Sinai Smidt Heart Institute Los Angeles CADivision of Cardiovascular Medicine, Brigham and Women’s Hospital Harvard Medical School Boston MABlavatnik Family Women’s Research Institute Icahn School of Medicine at Mount Sinai New York NYMount Sinai Fuster Heart Hospital Icahn School of Medicine at Mount Sinai New York NYDivision of Cardiovascular Medicine, Brigham and Women’s Hospital Harvard Medical School Boston MABackground Sex‐based differences in the association of lipoprotein(a) with cardiovascular outcomes have not been well established for those without prior atherosclerotic cardiovascular disease. Methods and Results Patients with no baseline atherosclerotic cardiovascular disease were identified in the MGB (Mass General Brigham) Lp(a) Registry, a retrospective cohort of patients who had lipoprotein(a) measured from 2000 to 2019. Lipoprotein(a) percentile groups were categorized as 1st to 50th (reference), 51st to 70th, 71st to 90th, and 91st to 100th. The primary outcome was a composite of fatal or nonfatal myocardial infarction, or fatal or nonfatal ischemic stroke. Cox proportional hazard modeling was used to assess the association of lipoprotein(a) with the primary outcome. Among 6238 patients with no baseline atherosclerotic cardiovascular disease, 45% were women. Women had higher total cholesterol, low‐density lipoprotein cholesterol, and median lipoprotein(a) (33.2 versus 28.9 nmol/L; P<0.001), whereas men had higher rates of diabetes and atrial fibrillation. Higher lipoprotein(a) was associated with an increased incidence of the primary composite outcome, with patients in the 91st to 100th percentile group (≥216 nmol/L) having an adjusted hazard ratio (HR) of 2.07 (95% CI, 1.31–3.25; P<0.01) in women and 2.39 (95% CI, 1.57–3.65; P<0.01) in men, with no interaction based on sex. When examining individual outcomes, the strongest association was present between lipoprotein(a) and fatal or nonfatal myocardial infarction (women: adjusted HR, 2.61 [95% CI, 1.48–4.61]; men: adjusted HR, 3.36 [95% CI, 2.01–5.60]). When stratifying by age, female sex was associated with a lower risk of fatal or nonfatal myocardial infarction in those aged <60 years; however, among older individuals, the risk conferred by elevated lipoprotein(a) was similar between men and women. Conclusions Among individuals with no prior atherosclerotic cardiovascular disease, elevated lipoprotein(a) is associated with higher rates of cardiovascular outcomes, particularly myocardial infarction, in both women and men.https://www.ahajournals.org/doi/10.1161/JAHA.124.035353coronary artery diseaselipoprotein(a)myocardial infarctionsex differences |
| spellingShingle | Gurleen Kaur Adam N. Berman David W. Biery Stephanie A. Besser Wanda Y. Wu Brittany Weber Michael C. Honigberg Khurram Nasir Martha Gulati Marcelo F. Di Carli Leslee J. Shaw Deepak L. Bhatt Ron Blankstein Sex Differences in the Association Between Lipoprotein(a) and Cardiovascular Outcomes: The MGB Lp(a) Registry Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease coronary artery disease lipoprotein(a) myocardial infarction sex differences |
| title | Sex Differences in the Association Between Lipoprotein(a) and Cardiovascular Outcomes: The MGB Lp(a) Registry |
| title_full | Sex Differences in the Association Between Lipoprotein(a) and Cardiovascular Outcomes: The MGB Lp(a) Registry |
| title_fullStr | Sex Differences in the Association Between Lipoprotein(a) and Cardiovascular Outcomes: The MGB Lp(a) Registry |
| title_full_unstemmed | Sex Differences in the Association Between Lipoprotein(a) and Cardiovascular Outcomes: The MGB Lp(a) Registry |
| title_short | Sex Differences in the Association Between Lipoprotein(a) and Cardiovascular Outcomes: The MGB Lp(a) Registry |
| title_sort | sex differences in the association between lipoprotein a and cardiovascular outcomes the mgb lp a registry |
| topic | coronary artery disease lipoprotein(a) myocardial infarction sex differences |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.035353 |
| work_keys_str_mv | AT gurleenkaur sexdifferencesintheassociationbetweenlipoproteinaandcardiovascularoutcomesthemgblparegistry AT adamnberman sexdifferencesintheassociationbetweenlipoproteinaandcardiovascularoutcomesthemgblparegistry AT davidwbiery sexdifferencesintheassociationbetweenlipoproteinaandcardiovascularoutcomesthemgblparegistry AT stephanieabesser sexdifferencesintheassociationbetweenlipoproteinaandcardiovascularoutcomesthemgblparegistry AT wandaywu sexdifferencesintheassociationbetweenlipoproteinaandcardiovascularoutcomesthemgblparegistry AT brittanyweber sexdifferencesintheassociationbetweenlipoproteinaandcardiovascularoutcomesthemgblparegistry AT michaelchonigberg sexdifferencesintheassociationbetweenlipoproteinaandcardiovascularoutcomesthemgblparegistry AT khurramnasir sexdifferencesintheassociationbetweenlipoproteinaandcardiovascularoutcomesthemgblparegistry AT marthagulati sexdifferencesintheassociationbetweenlipoproteinaandcardiovascularoutcomesthemgblparegistry AT marcelofdicarli sexdifferencesintheassociationbetweenlipoproteinaandcardiovascularoutcomesthemgblparegistry AT lesleejshaw sexdifferencesintheassociationbetweenlipoproteinaandcardiovascularoutcomesthemgblparegistry AT deepaklbhatt sexdifferencesintheassociationbetweenlipoproteinaandcardiovascularoutcomesthemgblparegistry AT ronblankstein sexdifferencesintheassociationbetweenlipoproteinaandcardiovascularoutcomesthemgblparegistry |