High Lp(a) levels ‘strongly associated’ with aortic dissection
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Data from a retrospective study suggest adults with very high levels of lipoprotein(a) are eight times more likely to experience aortic dissection compared with those with lower levels, independent of other CV risk factors.
“In the last 10 years, several large studies have found that Lp(a) is associated with an increased incidence of coronary heart disease, stroke and aortic stenosis; the association was shown to be independent of other risk factors,” Zhenzhong Zheng, MD, PhD, of the department of cardiovascular medicine at the First Affiliated Hospital of Nanchang University in Jiangxi, China, and colleagues wrote in Clinical Cardiology. “At the cellular and molecular level, inflammation and extracellular matrix degradation lead to changes in the structure of the aortic wall, and these changes promote the formation of aortic dissection.”
In a case-control study, Zheng and colleagues analyzed data from 200 adults with aortic dissection and 200 age- and sex-matched adults without aortic dissection. The mean age of patients was 54 years. Researchers retrospectively assessed data on hypertension, smoking, CAD, diabetes, Lp(a), total cholesterol, triglyceride level, LDL and HDL levels.
Researchers found that adults with aortic dissection had greater median Lp(a) concentrations compared with those without aortic dissection (median, 152.50 mg/L vs. 81.75 mg/L).
In logistic regression analyses adjusted for hypertension and smoking status, the top quartile of Lp(a) level was associated with an eightfold greater risk for aortic dissection (OR = 8.03; 95% CI, 2.850-22.62; P < .001), compared with the first quartile. In a model adjusted for CAD, CVD and diabetes, results persisted with an OR of 7.75 (95% CI, 2.61-23.03; P < .01). Results did not change in analyses stratified by age and sex.
“Due to the rapid onset of aortic dissection, its high mortality and poor prognosis, aortic dissection can lead to serious consequences in most cases,” the researchers wrote. “Thus, it is necessary to identify more potential risk factors and intervene on aortic dissection risk factors at an early stage to reduce the risk of aortic dissection.”
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