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Inicio Clínica e Investigación en Arteriosclerosis (English Edition) Clinical-epidemiological analysis of patients with elevated lipoprotein A in a t...
Journal Information
Vol. 36. Issue 3.
Pages 118-125 (May - June 2024)
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Vol. 36. Issue 3.
Pages 118-125 (May - June 2024)
Original article
Clinical-epidemiological analysis of patients with elevated lipoprotein A in a third level hospital
Análisis clínico-epidemiológico de pacientes con lipoproteína(a) elevada en un hospital de tercer nivel
Manuel García de Pradaa, Ramón Costa Segoviab,
Corresponding author
ramoncostasegovia@gmail.com

Corresponding author.
, Marta de Castro Martínezb, Nuria Valdeolivas Hidalgob, María Belén Sánchez Lópezb, Agustín Blanco Echevarríab
a Departamento de Medicina Interna, Universidad Complutense de Madrid, Hospital Universitario 12 de Octubre, Madrid, Spain
b Servicio de Medicina Interna, Fundación de Investigación Biomédica, Hospital Universitario 12 de Octubre, Madrid, Spain
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Figures (2)
Tables (3)
Table 1. Clinical and epidemiological parameters of the total sample.
Table 2. Analytical parameters of the total sample.
Table 3. Comparison of variables studied between patients with clinical or subclinical CVD and those without CVD.
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Additional material (1)
Abstract
Objective

The objective of the study is to describe the clinical and epidemiological characteristics of our patients with elevated Lp(a).

Materials and methods

A descriptive cross-sectional study was conducted on 316 patients with elevated Lp(a) (>125 nmol/L) in a random sample between January and August 2022. We measured epidemiological, anthropometric, clinical and laboratory variables (lipid metabolism parameters, carbohydrates and hormones).

Results

Mean age of our sample subject’s was 59 ± 15 years with 56% males. The average BMI was 27.6 kg/m2 (71% with elevated BMI). Elevated waist circumference was observed in 54.1% of men and 77.8% of women. 48% had hypertension, 30.7% had diabetes mellitus and 91.5% dyslipidemia. Only 39.7% of the patients had never smoked.

The mean values of total cholesterol were 158 ± 45 mg/dl, LDL was 81 ± 39 mg/dl, HDL was 53 ± 17 mg/dl, Triglycerides were 127 ± 61 mg/dl, and Lp(a) was 260 ± 129 nmol/l.

Regarding lipid lowering treatment, 89% were on statins, 68.6% on ezetimibe, and 13.7% on PCSK9 inhibitors. 177 patients (57,7%) had established cardiovascular disease (CVD), 16.3% had polyvascular disease, 11.7% had subclinical CVD, and 30.6% had no known CVD. Among patients with established CVD, 174 (98.3%) were on lipid-lowering treatment (97.2% on statins) and 86.4% were on antiplatelet therapy. The mean age of cardiovascular events was 55 ± 12 years in males and 60 ± 11 years in females. 65,1% of female and 56,2% of male patients suffered an early cardiovascular event.

Conclusions

Patients with elevated Lp(a) are at very high cardiovascular risk, particularly for early cardiovascular disease.

Keywords:
Lipoprotein(a)
Cardiovascular risk factors
Dyslipidemia
Cardiovascular risk stratification
Early cardiovascular disease
Resumen
Objetivo

El objetivo del estudio es describir las características clínico-epidemiológicas de nuestros pacientes con Lp(a) elevada.

Material y métodos

Estudio descriptivo transversal de 316 pacientes con Lp(a) elevada (>125 nmol/l) en una muestra aleatoria entre enero y agosto de 2022, midiendo variables epidemiológicas, antropométricas, clínicas y analíticas (parámetros del metabolismo lipídico, hidratos de carbono y hormonales).

Resultados

La edad media de los sujetos de la muestra fue de 59 ± 15 años con 56% varones. El índice de masa corporal (IMC) medio fue de 27,6 kg/m2 (71% de IMC elevado). Un perímetro abdominal aumentado en 54,1% de los hombres y 77,8% de mujeres. Un total de 48% con hipertensión arterial (HTA), 30,7% de diabetes mellitus (DM) y 91,5% con dislipemia. Solo 39,7% de los sujetos nunca habían fumado. Los valores medios de colesterol total fueron de 158 ± 45 mg/dL, lipoproteína de baja densidad (LDL) de 81 ± 39 mg/dL, lipoproteína de alta densidad (HDL) de 53 ± 17 mg/dL, triglicéridos (TG) de 127 ± 61 mg/dL y Lp(a) de 260 ± 129 nmol/L. Con respecto al tratamiento hipolipemiante, 89% estaban con estatinas, 68,6% con ezetimiba y 13,7% con los inhibidores de proproteína convertasa subtilisin/kexin tipo 9 (iPCSK9). Un total de 177 pacientes (57,7%) padecían enfermedad cardiovascular (ECV) establecida, de ellos 16,3% enfermedad polivascular. Además, había 11,7% usuarios con ECV subclínica y 30,6% sin ECV conocida. Aquellos con ECV establecida, 174 (98,3%), estaban con terapia hipolipemiante (97,2% con estatinas) y 86,4% antiagregados. La edad media de evento cardiovascular fue 55 ± 12 años en varones y 60 ± 11 en mujeres. Presentando 65,1% de ellas y 56,2% de los hombres un evento cardiovascular precoz.

Conclusiones

Los pacientes con Lp(a) elevada son pacientes de muy alto riesgo cardiovascular y en especial de ECV precoz.

Palabras clave:
Lipoproteína(a)
Factores de riesgo cardiovascular
Dislipemia
Estratificación de riesgo cardiovascular
Enfermedad cardiovascular precoz

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