Geographical Variation in Lipoprotein (a) Levels Among CHD Patients

A global study suggested that most patients with coronary heart disease (CHD) have Lipoprotein (a) [Lp(a)] levels below risk-enhancing thresholds with wide geographical variations. The study assessed Lp(a) levels in 3,928 CHD patients across 13 countries in six World Health Organization regions. Median Lp(a) level was 32 nmol/L, with 17.6% of patients exceeding the 125 nmol/L threshold associated with increased cardiovascular risk. Substantial variation was observed between regions and countries, with the highest median levels found in Africa (62 nmol/L) and the lowest in the Western Pacific (22 nmol/L). The proportion of patients with Lp(a) ≥150, 175, and 200 nmol/L—potentially eligible for future Lp(a)-targeted therapies—was 13.0%, 9.3%, and 6.2%, respectively, also varying significantly by country. These findings highlight the need to consider geographical differences when designing and implementing Lp(a)-lowering strategies, as fixed thresholds may affect equitable access to future therapies. Lp(a) is a well-established risk factor for atherosclerotic cardiovascular disease and may be more atherogenic per particle than low-density lipoprotein. Source: https://www.jacc.org/