The Association of Lipoprotein(A) and Coronary Artery Calcium in Primary Prevention Patients—Data from the STAR-Lp(A) Study
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Endpoints
2.3. Statistical Analysis
3. Results
4. Discussion
4.1. Strengths and Limitations
Clinical Implications and Future Research
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | All Me (IQR)/N (%) | Lipoprotein(a) Me (IQR)/N(%) | CAC Me (IQR)/N(%) | |||||||
---|---|---|---|---|---|---|---|---|---|---|
<30 mg/dL N = 390 | 30–50 mg/dL N = 40 | ≥50 mg/dL N = 98 | p | 0 N = 189 | 1–100 N = 159 | >100 N = 180 | p | |||
Age, years | 68.0 (12.0) | 68.0 (11.0) | 69.0 (13.0) | 68.0 (13.0) | 0.58 | 63.0 (16.0) | 68.0 (10.0) | 71.0 (8.0) | 0.04 | |
Sex | Male | 179 (33.9) | 138 (35.4) | 15 (37.5) | 26 (26.5) | 0.25 | 44 (23.3) | 57 (35.9) | 78 (43.3) | <0.001 |
Female | 349 (66.1) | 252 (64.6) | 25 (62.5) | 72 (73.5) | 146 (76.7) | 101 (64.1) | 102 (56.7) | |||
Hypertension | 350 (66.3) | 260 (66.8) | 21 (52.5) | 69 (70.4) | 0.12 | 106 (56.1) | 105 (66.0) | 139 (77.2) | <0.001 | |
Diabetes | 119 (22.5) | 95 (24.4) | 7 (17.5) | 17 (17.4) | 0.24 | 36 (19.1) | 35 (22.0) | 48 (26.7) | 0.21 | |
Hyperlipidemia | 133 (25.2) | 101 (25.9) | 11 (27.5) | 21 (21.4) | 0.62 | 47 (24.9) | 45 (28.3) | 41 (22.8) | 0.50 | |
Hypothyroidism | 99 (18.6) | 73 (18.7) | 5 (12.5) | 21 (21.4) | 0.48 | 39 (20.6) | 34 (21.4) | 26 (14.4) | 0.19 | |
Asthma | 54 (10.2) | 41(10.5) | 4 (10.0) | 9(9.2) | 0.93 | 15 (7.9) | 16 (10.1) | 23 (12.8) | 0.31 | |
COPD | 30 (5.7) | 20 (5.1) | 2 (5.0) | 8 (8.2) | 0.50 | 6 (3.2) | 9 (5.7) | 15 (8.3) | 0.10 | |
Rheumatoid arthritis | 21 (3.9) | 16 (4.1) | 1 (2.5) | 4 (4.1) | 0.88 | 3 (1.6) | 12 (7.6) | 6 (3.3) | 0.02 | |
Anxiety disorders | 224 (42.4) | 169 (43.3) | 14 (35.0) | 41 (41.8) | 0.59 | 87 (46.0) | 63 (39.6) | 74 (41.1) | 0.44 | |
Depression | 270 (51.1) | 208 (53.3) | 18 (45.0) | 44 (44.9) | 0.24 | 103 (54.5) | 82 (51.6) | 85 (47.2) | 0.37 | |
Sleep disorders | 231 (43.8) | 177 (45.4) | 15 (37.5) | 39 (39.8) | 0.43 | 89 (47.1) | 72 (45.3) | 70 (38.9) | 0.25 | |
Sleep apnea | 125 (23.7) | 98 (25.1) | 3 (7.5) | 24 (24.5) | 0.04 | 49 (25.9) | 37 (23.3) | 39 (21.7) | 0.62 | |
Migraine | 54 (10.2) | 42 (10.8) | 1 (2.5) | 11 (11.2) | 0.24 | 30 (15.9) | 15 (9.4) | 9 (5.0) | 0.002 | |
Erection disorders | 28 (5.3) | 23 (5.9) | 2 (5.0) | 3 (3.1) | 0.53 | 5 (2.7) | 11 (6.9) | 12 (6.7) | 0.13 | |
Regular physical activity | 202 (38.3) | 154 (39.5) | 9 (22.5) | 39 (39.8) | 0.10 | 70 (37.0) | 66 (41.5) | 66 (36.7) | 0.60 | |
Smoking | 62 (11.7) | 44 (11.3) | 5 (12.5) | 13 (13.3) | 0.85 | 17 (9.0) | 18 (11.3) | 27 (15.0) | 0.20 | |
Lipid lowering drugs | 176 (33.3) | 160 (33.6) | 22 (30.0) | 33 (33.7) | 0.90 | 43 (22.8) | 51 (32.1) | 82 (45.6) | <0.001 | |
BMI kg/m2 | 27.8 (6.1) | 27.8 (6.2) | 26.9 (6.6) | 28.8 (6.1) | 0.45 | 27.3 (6.2) | 28.0 ± 6.2 | 28.0 (6.1) | 0.31 | |
Creatinine mg/dL | 0.8 (0.2) | 0.8 (0.2) | 0.8 (0.2) | 0.8 (0.2) | 0.24 | 0.8 (0.2) | 0.8 (0.2) | 0.8 (0.2) | 0.17 | |
Glucose mg/dL | 103.0 (24.0) | 102.0 (24.0) | 96.0 (29.0) | 109.0 (23.0) | 0.26 | 99.0 (26.0) | 103 (20.5) | 107.0 (23.0) | 0.02 | |
Homocysteine µmol/L | 11.8 (4.2) | 11.8 (4.3) | 10.6 (4.4) | 12.0 (4.1) | 0.45 | 11.1 (4.3) | 11.7 (4.0) | 12.4 (3.9) | 0.02 | |
Hemoglobin A1C (%) | 5.7 (0.6) | 5.6 (0.5) | 5.5 (0.6) | 5.5 (0.5) | 0.30 | 5.5 (0.6) | 5.6 (0.6) | 5.6 (0.6) | 0.01 | |
TSH µU/mL | 2.0 (1.4) | 1.5 (1.4) | 1.4 (1.6) | 1.5 (1.3) | 0.95 | 1.4 (1.3) | 1.6 (1.6) | 1.5 (1.4) | 0.70 | |
CAC AU | 23.5 (208.0) | 23.0 (183.0) | 0.0 (242.5) | 35.0 (241.0) | 0.27 | 0.0 (0.0) | 26.0 (38.0) | 391.5 (657.5) | --- | |
LDL-C (mg/dL) | 105.0 (57.0) | 104.0 (57.0) | 122.0 (75.0) | 104.0 (53.0) | 0.07 | 110.0 (51.0) | 103.5 (64.0) | 100.5 (56.0) | 0.09 | |
TG (mg/dL) | 116.0 (62.0) | 116.0 (63.0) | 115.0 (52.0) | 118.0 (63.0) | 0.81 | 116.0 (63.5) | 121.5 (68.5) | 114.0 (56.0) | 0.49 | |
HDL-C (mg/dL) | 52.0 (20.0) | 52.0 (19.0) | 49.5 (18.5) | 52.0 (19.0) | 0.39 | 55.5 (19.0) | 50.5 (21.0) | 52.0 (20.0) | 0.16 | |
Non-HDL (mg/dL) | 131.0 (59.0) | 129.5 (58.5) | 145.5 (72.5) | 132.0 (58.0) | 0.33 | 132.0 (64.0) | 130.5 (65.0) | 130.5 (53.0) | 0.85 | |
Lp(a) mg/dL | 10.0 (28.0) | 6.0 (7.8) | 40.0 (9.0) | 80.0 (40.0) | --- | 10.0 (29.5) | 8.0 (21.1) | 10.0 (27.1) | 0.20 |
Variable | OR | 95% CI | p-Value |
---|---|---|---|
Lp(a) per 10 mg/dL | 1.02 | 0.97–1.07 | 0.53 |
Age per 10 years | 2.61 | 2.02–3.38 | <0.001 |
Sex (female) | 0.21 | 0.12–0.35 | <0.001 |
Hypertension | 1.40 | 0.88–2.22 | 0.15 |
Diabetes | 1.43 | 0.84–2.44 | 0.18 |
Smoking | 2.25 | 1.12–4.53 | 0.02 |
BMI (kg/m2) | 0.97 | 0.93–1.02 | 0.24 |
LDL cholesterol per 10 mg/dL | 1.01 | 0.96–1.07 | 0.69 |
Creatinine per 0.1 mg/dL | 0.97 | 0.88–1.07 | 0.49 |
Statin therapy | 1.70 | 1.08–2.69 | 0.02 |
Variable | OR [95Cl] | p |
---|---|---|
Sex, female | 4.12 [2.54–6.67] | <0.001 |
Age, per 10 years | 0.22 [0.14–0.33] | <0.001 |
Hypertension | 0.59 [0.39–0.91] | 0.02 |
Lipid lowering drugs | 0.51 [0.33–0.82] | 0.01 |
Smoking | 0.48 [0.24–0.93] | 0.03 |
Variable | CAC = 0 | p | CAC = 0–50 | p | CAC > 100 | p | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Lp(a) < 30 N = 137 | Lp(a) = 30–50 N = 21 | Lp(a) > 50 N = 31 | Lp(a) < 30 N = 121 | Lp(a) = 30–50 N = 8 | Lp(a) > 50 N = 30 | Lp(a) < 30 N = 132 | Lp(a) = 30–50 N = 11 | Lp(a) > 50 N = 37 | |||||
Me (IQR)/n (%) | Me (IQR)/n (%) | Me (IQR)/n (%) | |||||||||||
Age | 63.0 (16.0) | 67.0 (17.0) | 62.0 (15.0) | 0.88 | 68.0 (9.0) | 71.0 (10.0) | 68.0 (20.0) | 0.61 | 71.0 (8.0) | 73.0 (5.0) | 72.0 (8.0) | 0.64 | |
Sex | Male | 29 (21.2) | 9 (42.9) | 6 (19.4) | 0.08 | 45 (37.2) | 3 (37.5) | 9 (30.0) | 0.76 | 64 (48.5) | 3 (27.3) | 11 (29.7) | 0.07 |
Female | 108 (78.8) | 12 (57.1) | 25 (80.6) | 76 (62.8) | 5 (62.5) | 21 (70.0) | 68 (51.5) | 8 (72.7) | 26 (70.3) | ||||
Hypertension | 76 (55.5) | 9 (42.9) | 21 (67.7) | 0.91 | 82 (67.8) | 3 (37.5) | 20 (60.7) | 0.22 | 102 (77.3) | 9 (81.8) | 28 (75.7) | 0.91 | |
Diabetes | 26 (18.9) | 5 (23.8) | 5 (16.1) | 0.79 | 31 (25.6) | 0 (0.0) | 4 (13.3) | 0.11 | 38 (28.8) | 2 (18.2) | 8 (21.6) | 0.55 | |
Hyperlipidemia | 35 (25.6) | 6 (28.6) | 6 (19.4) | 0.71 | 35 (28.9) | 1 (12.5) | 9 (30.0) | 0.59 | 31 (23.5) | 4 (36.4) | 6 (16.2) | 0.35 | |
Hypothyroidism | 27 (19.7) | 3 (14.3) | 9 (29.0) | 0.38 | 27 (22.3) | 2 (25.0) | 5 (16.7) | 0.77 | 19 (14.4) | 0 (0.0) | 7 (18.9) | 0.29 | |
Asthma | 13 (9.5) | 1 (4.8) | 1 (3.2) | 0.43 | 13 (10.7) | 0 (0.0) | 3 (10.0) | 0.62 | 15 (11.4) | 3 (27.3) | 5 (13.5) | 0.31 | |
COPD | 4 (2.9) | 0 (0.0) | 2 (6.5) | 0.41 | 6 (4.9) | 0 (0.0) | 3 (10.0) | 0.44 | 10 (7.6) | 2 (18.2) | 3 (8.1) | 0.47 | |
RA | 2 (1.5) | 0 (0.0) | 1 (3.2) | 0.64 | 10 (8.3) | 1 (12.5) | 1 (3.3) | 0.57 | 4 (3.0) | 0 (0.0) | 2 (5.4) | 0.63 | |
Anxiety disorders | 70 (51.1) | 6 (28.6) | 11 (35.5) | 0.07 | 46 (38.0) | 3 (37.5) | 14 (46.7) | 0.68 | 53 (40.2) | 5 (45.5) | 16 (43.2) | 0.90 | |
Depression | 81 (59.1) | 9 (42.9) | 13 (41.9) | 0.12 | 64 (52.9) | 2 (25.0) | 16 (53.3) | 0.30 | 63 (47.7) | 7 (63.6) | 15 (40.5) | 0.39 | |
Sleep disorders | 70 (51.1) | 7 (33.3) | 12 (38.7) | 0.19 | 56 (46.3) | 2 (25.0) | 14 (46.7) | 0.49 | 51 (38.6) | 6 (54.6) | 13 (35.1) | 0.51 | |
Sleep apnea | 40 (29.2) | 1 (4.8) | 8 (25.8) | 0.06 | 33 (27.3) | 0 (0.0) | 4 (13.3) | 0.08 | 25 (18.9) | 2 (18.2) | 12 (32.4) | 0.20 | |
Migraine | 24 (17.5) | 1 (4.8) | 5 (16.1) | 0.33 | 12 (9.9) | 0 (0.0) | 3 (10.0) | 0.64 | 6 (4.6) | 0 (0.0) | 3 (8.1) | 0.49 | |
Erection disorders | 4 (2.9) | 0 (0.0) | 1 (3.2) | 0.72 | 9 (7.4) | 0 (0.0) | 2 (6.7) | 0.72 | 10 (7.6) | 2 (18.2) | 0 (0.0) | 0.08 | |
Regular physical activity | 52 (37.9) | 5 (23.8) | 13 (41.9) | 0.38 | 51 (42.2) | 0 (0.0) | 15 (50.0) | 0.04 | 51 (38.6) | 4 (36.4) | 11 (29.7) | 0.61 | |
Smoking | 15 (10.9) | 0 (0.0) | 2 (6.5) | 0.23 | 12 (9.9) | 1 (12.5) | 5 (16.7) | 0.58 | 17 (12.9) | 4 (36.4) | 6 (16.1) | 0.11 | |
Lipid lowering drugs | 33 (24.1) | 3 (14.3) | 7 (22.6) | 0.61 | 38 (31.4) | 2 (25.0) | 11 (36.7) | 0.78 | 60 (45.5) | 7 (63.6) | 15 (40.5) | 0.40 | |
BMI | 27.6 (6.0) | 25.6 (5.6) | 26.9 (8.3) | 0.43 | 28.5 (6.2) | 29.6 (6.7) | 28.4 (6.4) | 0.77 | 27.7 (6.3) | 27.0 (9.3) | 28.7 (5.8) | 0.38 | |
Creatinine (mg/dL) | 0.8 (0.2) | 0.8 (0.2) | 0.7 (0.2) | 0.06 | 0.8 (0.2) | 0.9 (0.4) | 0.8 (0.2) | 0.60 | 0.8 (0.3) | 0.8 (0.3) | 0.8 (0.2) | 0.64 | |
Glucose (mg/dL) | 99.0 (23.0) | 91.0 (21.0) | 110.0 (25.0) | 0.25 | 102.0 (21.0) | 107.5 (23.0) | 101.0 (21.0) | 0.65 | 107.0 (23.0) | 116.5 (21.0) | 109.0 (28.0) | 0.30 | |
Homocysteine µmol/L | 10.4 (4.7) | 11.2 (2.6) | 10.9 (3.7) | 0.43 | 11.6 (3.8) | 10.9 (4.2) | 12.0 (4.2) | 0.37 | 12.2 (3.9) | 12.7 (7.1) | 13.0 (3.7) | 0.64 | |
Hemoglobin A1C, % | 5.5 (0.7) | 5.4 (0.6) | 5.4 (0.5) | 0.51 | 5.6 (0.6) | 5.6 (0.5) | 5.6 (0.4) | 0.90 | 5.6 (0.6) | 5.5 (0.2) | 5.6 (0.9) | 0.16 | |
TSH (µU/mL) | 1.4 (1.2) | 1.3 (0.9) | 1.7 (1.2) | 0.37 | 1.5 (1.7) | 2.0 (1.5) | 1.6 (1.6) | 0.32 | 1.6 (1.3) | 1.6 (1.9) | 1.4 (1.4) | 0.56 | |
LDL-C (mg/dL) | 109.0 (50.0) | 112.0 (59.0) | 119.0 (54.0) | 0.11 | 103.0 (61.5) | 115.0 (64.5) | 102.5 (59.0) | 0.65 | 101.0 (55.0) | 79.0 (87.0) | 97.0 (49.0) | 0.55 | |
TG (mg/dL) | 115.0 (73.0) | 119.0 (77.0) | 116.0 (55.0) | 0.30 | 124.0 (70.0) | 114.5 (40.0) | 111.5 (67.0) | 0.34 | 1212.5 (52.0) | 108.0 (28.0) | 128.0 (63.0) | 0.64 | |
Non-HDL (mg/dL) | 127.5 (60.5) | 151.0 (57.0) | 132.0 (66.0) | 0.42 | 130.0 (65.0) | 139.5 (66.0) | 128.0 (70.0) | 0.44 | 129.5 (53.0) | 162.0 (10.0) | 132.0 (49.0) | 0.31 | |
HDL (mg/dL) | 56.0 (19.5) | 50.0 (19.0) | 56.0 (23.0) | 0.39 | 50.0 (21.0) | 47.0 (12.0) | 53.5 (19.0) | 0.32 | 53.0 (22.0) | 52.0 (21.0) | 48.0 (17.0) | 0.14 | |
Lp(a) (mg/dL) | 6.0 (8.8) | 40.0 (5.0) | 78.0 (39.2) | <0.001 | 5.4 (7.0) | 43.9 (9.5) | 80.0 (39.1) | <0.001 | 7.0 (7.9) | 38.0 (8.0) | 84.0 (37.0) | <0.001 |
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Burzyńska, M.; Jankowski, P.; Babicki, M.; Banach, M.; Chudzik, M. The Association of Lipoprotein(A) and Coronary Artery Calcium in Primary Prevention Patients—Data from the STAR-Lp(A) Study. J. Clin. Med. 2025, 14, 6713. https://doi.org/10.3390/jcm14196713
Burzyńska M, Jankowski P, Babicki M, Banach M, Chudzik M. The Association of Lipoprotein(A) and Coronary Artery Calcium in Primary Prevention Patients—Data from the STAR-Lp(A) Study. Journal of Clinical Medicine. 2025; 14(19):6713. https://doi.org/10.3390/jcm14196713
Chicago/Turabian StyleBurzyńska, Monika, Piotr Jankowski, Mateusz Babicki, Maciej Banach, and Michał Chudzik. 2025. "The Association of Lipoprotein(A) and Coronary Artery Calcium in Primary Prevention Patients—Data from the STAR-Lp(A) Study" Journal of Clinical Medicine 14, no. 19: 6713. https://doi.org/10.3390/jcm14196713
APA StyleBurzyńska, M., Jankowski, P., Babicki, M., Banach, M., & Chudzik, M. (2025). The Association of Lipoprotein(A) and Coronary Artery Calcium in Primary Prevention Patients—Data from the STAR-Lp(A) Study. Journal of Clinical Medicine, 14(19), 6713. https://doi.org/10.3390/jcm14196713