Lipoprotein(a) is not associated with venous thromboembolism risk

Abstract

Objectives. Evidence from case-control studies as well as meta-analyses of these study designs suggest elevated lipoprotein(a) [Lp(a)] to be associated with an increased risk of venous thromboembolism (VTE). Prospective evidence on the association is limited, uncertain, and could be attributed to regression dilution bias. We aimed to assess the prospective association of Lp(a) with risk of VTE and correct for regression dilution. Design. We related plasma Lp(a) concentrations to the incidence of VTE in 2,180 A c c e p t e d M a n u s c r i p t 2 men of the Kuopio Ischemic Heart Disease cohort study. Hazard ratios (HRs) (95% confidence intervals [CI]) were assessed and repeat measurements of Lp(a) at 4 and 11 years from baseline, were used to correct for within-person variability. Results. After a median follow-up of 24.9 years, 110 validated VTE cases were recorded. The regression dilution ratio of log e Lp(a) adjusted for age was 0.85 (95% CI: 0.82-0.89). In analyses adjusted for several established risk factors and potential confounders, the HR (95% CI) for VTE per 1 SD (equivalent to 3.56-fold) higher baseline log e Lp(a) was 1.06 (0.87-1.30). In pooled analysis of five population-based cohort studies (including the current study) comprising 66,583 participants and 1,314 VTE cases, the fully-adjusted corresponding HR for VTE was 1.00 (95% CI: 0.94-1.07), with no evidence of heterogeneity between studies. Conclusions. Primary analysis as well as pooled evidence from previous studies suggest circulating Lp(a) is not prospectively associated with future VTE risk, indicating that evidence of associations demonstrated in case-control designs may be driven by biases such as selection bias.

Non-Lipid Effects of PCSK9 Monoclonal Antibodies on Vessel Wall

“…Several case-control studies have shown increased VTE risk with elevated Lp(a) concentrations [79][80][81]. On the contrary, a population-based prospective study in 2180 middle-aged men without a history of VTE at the study entry showed no evidence of an association of circulating Lp(a) with the risk of VTE [82]. These results are similar to previous prospective studies in different populations [83][84][85][86].…”

Osteonecrosis of the Jaws in Patients with Hereditary Thrombophilia/Hypofibrinolysis—From Pathophysiology to Therapeutic Implications

“…However, the association between Lp(a) and VTE is not yet well clarified. While a meta-analysis and several other studies show a significant association between high levels of Lp(a) and increased risk of VTE in adults [ 139 , 140 , 141 , 142 ], other studies did not confirm this association [ 143 , 144 , 145 ].…”

Predicting the occurrence of venous thromboembolism: construction and verification of risk warning model

“…The VTE prediction model were established with purpose of making accurate assessment and diagnosis of VTE in the first time and avoiding adulterating human factors as much as possible. We know that there is a lot of VTE-related information in the electronic medical record system [27,[33][34][35][39][40][41], and such information needs to be further explored and fully utilized in the clinical VTE warning. The VTE risk warning model made full use of Caprini risk assessment scale, which was widely used in clinical medicine and surgery, with the important clinical symptoms and signs of VTE patients and laboratory examination indicators, to carry out comprehensive and multi-dimensional warning and achieve higher prediction efficiency.…”