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Circulating lipoprotein (a) and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis
AIMS: To investigate the association between circulating lipoprotein(a) (Lp(a)) and risk of all-cause and cause-specific mortality in the general population and in patients with chronic diseases, and to elucidate the dose-response relations. METHODS AND RESULTS: We searched literature to find prospe...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Netherlands
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10164031/ https://www.ncbi.nlm.nih.gov/pubmed/36708412 http://dx.doi.org/10.1007/s10654-022-00956-4 |
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author | Amiri, Mojgan Raeisi-Dehkordi, Hamidreza Verkaar, Auke J.C.F Wu, Yahong van Westing, Anniek C. Berk, Kirsten A. Bramer, Wichor M. Aune, Dagfinn Voortman, Trudy |
author_facet | Amiri, Mojgan Raeisi-Dehkordi, Hamidreza Verkaar, Auke J.C.F Wu, Yahong van Westing, Anniek C. Berk, Kirsten A. Bramer, Wichor M. Aune, Dagfinn Voortman, Trudy |
author_sort | Amiri, Mojgan |
collection | PubMed |
description | AIMS: To investigate the association between circulating lipoprotein(a) (Lp(a)) and risk of all-cause and cause-specific mortality in the general population and in patients with chronic diseases, and to elucidate the dose-response relations. METHODS AND RESULTS: We searched literature to find prospective studies reporting adjusted risk estimates on the association of Lp(a) and mortality outcomes. Forty-three publications, reporting on 75 studies (957,253 participants), were included. The hazard ratios (HRs) and 95% confidence intervals (95%CI ) for the top versus bottom tertile of Lp(a) levels and risk of all-cause mortality were 1.09 (95%CI: 1.01–1.18, I(2): 75.34%, n = 19) in the general population and 1.18 (95%CI: 1.04–1.34, I(2): 52.5%, n = 12) in patients with cardiovascular diseases (CVD). The HRs for CVD mortality were 1.33 (95%CI: 1.11–1.58, I(2): 82.8%, n = 31) in the general population, 1.25 (95%CI: 1.10–1.43, I(2): 54.3%, n = 17) in patients with CVD and 2.53 (95%CI: 1.13–5.64, I(2): 66%, n = 4) in patients with diabetes mellitus. Linear dose-response analyses revealed that each 50 mg/dL increase in Lp(a) levels was associated with 31% and 15% greater risk of CVD death in the general population and in patients with CVD. No non-linear dose-response association was observed between Lp(a) levels and risk of all-cause or CVD mortality in the general population or in patients with CVD (P(nonlinearity) > 0.05). CONCLUSION: This study provides further evidence that higher Lp(a) levels are associated with higher risk of all-cause mortality and CVD-death in the general population and in patients with CVD. These findings support the ESC/EAS Guidelines that recommend Lp(a) should be measured at least once in each adult person’s lifetime, since our study suggests those with higher Lp(a) might also have higher risk of mortality. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10654-022-00956-4. |
format | Online Article Text |
id | pubmed-10164031 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Netherlands |
record_format | MEDLINE/PubMed |
spelling | pubmed-101640312023-05-08 Circulating lipoprotein (a) and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis Amiri, Mojgan Raeisi-Dehkordi, Hamidreza Verkaar, Auke J.C.F Wu, Yahong van Westing, Anniek C. Berk, Kirsten A. Bramer, Wichor M. Aune, Dagfinn Voortman, Trudy Eur J Epidemiol Review AIMS: To investigate the association between circulating lipoprotein(a) (Lp(a)) and risk of all-cause and cause-specific mortality in the general population and in patients with chronic diseases, and to elucidate the dose-response relations. METHODS AND RESULTS: We searched literature to find prospective studies reporting adjusted risk estimates on the association of Lp(a) and mortality outcomes. Forty-three publications, reporting on 75 studies (957,253 participants), were included. The hazard ratios (HRs) and 95% confidence intervals (95%CI ) for the top versus bottom tertile of Lp(a) levels and risk of all-cause mortality were 1.09 (95%CI: 1.01–1.18, I(2): 75.34%, n = 19) in the general population and 1.18 (95%CI: 1.04–1.34, I(2): 52.5%, n = 12) in patients with cardiovascular diseases (CVD). The HRs for CVD mortality were 1.33 (95%CI: 1.11–1.58, I(2): 82.8%, n = 31) in the general population, 1.25 (95%CI: 1.10–1.43, I(2): 54.3%, n = 17) in patients with CVD and 2.53 (95%CI: 1.13–5.64, I(2): 66%, n = 4) in patients with diabetes mellitus. Linear dose-response analyses revealed that each 50 mg/dL increase in Lp(a) levels was associated with 31% and 15% greater risk of CVD death in the general population and in patients with CVD. No non-linear dose-response association was observed between Lp(a) levels and risk of all-cause or CVD mortality in the general population or in patients with CVD (P(nonlinearity) > 0.05). CONCLUSION: This study provides further evidence that higher Lp(a) levels are associated with higher risk of all-cause mortality and CVD-death in the general population and in patients with CVD. These findings support the ESC/EAS Guidelines that recommend Lp(a) should be measured at least once in each adult person’s lifetime, since our study suggests those with higher Lp(a) might also have higher risk of mortality. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10654-022-00956-4. Springer Netherlands 2023-01-28 2023 /pmc/articles/PMC10164031/ /pubmed/36708412 http://dx.doi.org/10.1007/s10654-022-00956-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Review Amiri, Mojgan Raeisi-Dehkordi, Hamidreza Verkaar, Auke J.C.F Wu, Yahong van Westing, Anniek C. Berk, Kirsten A. Bramer, Wichor M. Aune, Dagfinn Voortman, Trudy Circulating lipoprotein (a) and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis |
title | Circulating lipoprotein (a) and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis |
title_full | Circulating lipoprotein (a) and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis |
title_fullStr | Circulating lipoprotein (a) and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis |
title_full_unstemmed | Circulating lipoprotein (a) and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis |
title_short | Circulating lipoprotein (a) and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis |
title_sort | circulating lipoprotein (a) and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10164031/ https://www.ncbi.nlm.nih.gov/pubmed/36708412 http://dx.doi.org/10.1007/s10654-022-00956-4 |
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