Back to Search
Start Over
Estimating the Population Impact of Lp(a) Lowering on the Incidence of Myocardial Infarction and Aortic Stenosis-Brief Report.
- Source :
-
Arteriosclerosis, thrombosis, and vascular biology [Arterioscler Thromb Vasc Biol] 2016 Dec; Vol. 36 (12), pp. 2421-2423. Date of Electronic Publication: 2016 Oct 20. - Publication Year :
- 2016
-
Abstract
- Objective: High lipoprotein(a) (Lp[a]) is the most common genetic dyslipidemia and is a causal factor for myocardial infarction (MI) and aortic stenosis (AS). We sought to estimate the population impact of Lp(a) lowering that could be achieved in primary prevention using the therapies in development.<br />Approach and Results: We used published data from 2 prospective cohorts. High Lp(a) was defined as ≥50 mg/dL (≈20th percentile). Relative risk, attributable risk, the attributable risk percentage, population attributable risk, and the population attributable risk percentage were calculated as measures of the population impact. For MI, the event rate was 4.0% versus 2.8% for high versus low Lp(a) (relative risk, 1.46; 95% confidence interval [CI], 1.45-1.46). The attributable risk was 1.26% (95% CI, 1.24-1.27), corresponding to 31.3% (95% CI, 31.0-31.7) of the excess MI risk in those with high Lp(a). The population attributable risk was 0.21%, representing a population attributable risk percentage of 7.13%. For AS, the event rate was 1.51% versus 0.78% for high versus low Lp(a) (relative risk, 1.95; 95% CI, 1.94-1.97). The attributable risk was 0.74% (95% CI, 0.73-0.75), corresponding to 48.8% (95% CI, 48.3-49.3) of the excess AS risk in those with high Lp(a). The population attributable risk was 0.13%, representing a population attributable risk percentage of 13.9%. In sensitivity analyses targeting the top 10% of Lp(a), the population attributable risk percentage was 5.2% for MI and 7.8% for AS.<br />Conclusions: Lp(a) lowering among the top 20% of the population distribution for Lp(a) could prevent 1 in 14 cases of MI and 1 in 7 cases of AS, suggesting a major impact on reducing the burden of cardiovascular disease. Targeting the top 10% could prevent 1 in 20 MI cases and 1 in 12 AS cases.<br /> (© 2016 American Heart Association, Inc.)
- Subjects :
- Aortic Valve Stenosis diagnosis
Aortic Valve Stenosis epidemiology
Biomarkers blood
Denmark epidemiology
Down-Regulation
Humans
Hyperlipoproteinemias blood
Hyperlipoproteinemias diagnosis
Hyperlipoproteinemias epidemiology
Hypolipidemic Agents adverse effects
Incidence
Myocardial Infarction diagnosis
Myocardial Infarction epidemiology
Prospective Studies
Protective Factors
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Aortic Valve Stenosis prevention & control
Hyperlipoproteinemias drug therapy
Hypolipidemic Agents therapeutic use
Lipoprotein(a) blood
Myocardial Infarction prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4636
- Volume :
- 36
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Arteriosclerosis, thrombosis, and vascular biology
- Publication Type :
- Academic Journal
- Accession number :
- 27765771
- Full Text :
- https://doi.org/10.1161/ATVBAHA.116.308271