The association between lipoprotein(a) levels and the development of cardiac allograft vasculopathy

Mohammed Tiseer Abbas, Kamal Awad, Juan  M M. Farina, Ahmed  K K. Mahmoud, Milagros Pereyra, Isabel  G G. Scalia, Moaz  A A. Kamel, Nima Baba Ali, Said Alsidawi, Steven  J J. Lester, Vuyisile  T T. Nkomo, Parag  C C. Patel, Kristen  A A. Sell-Dottin, Andrew N. Rosenbaum, Grace Lin, Brian  W W. Hardaway, D․ Eric Steidley, Robert  L L. Scott, Lisa  M M. LeMond, Julie  L L. RosenthalChadi Ayoub, Reza Arsanjani

Research output: Contribution to journalArticlepeer-review

Abstract

Lipoprotein(a) [Lp(a)] has been established as an independent risk factor for cardiovascular diseases. However, its role in cardiac allograft vasculopathy (CAV) development remains controversial. In a retrospective cohort study of 385 patients who underwent heart transplant between 2001 and 2023, Lp(a) concentrations were compared between patients with and without clinically significant CAV (grade 0-1 vs 2-3). Preoperative Lp(a) concentrations were not significantly different between patients with and without CAV (14.0 vs 12.0 mg/dL, P = .42). High (≥50 mg/dL) Lp(a) values were not associated with CAV development on univariable or multivariable analysis (hazard ratio [HR] 1.009, 95% CI: 0.47-2.14, P = .9). A history of graft rejection was the only independent factor associated with CAV (HR 2.88, 95 % CI: 1.50-5.52, P = .001). Elevated Lp(a) levels were not associated with increased risk of CAV. The lack of a significant association between traditional risk factors and CAV underscores that CAV is not purely an atherosclerotic process and different pathophysiological mechanisms are involved.

Original languageEnglish (US)
Pages (from-to)364-368
Number of pages5
JournalJournal of Clinical Lipidology
Volume19
Issue number2
DOIs
StatePublished - Mar 1 2025

Keywords

  • Cardiac allograft vasculopathy
  • Coronary angiography
  • Coronary artery disease
  • Heart transplant
  • Lipoprotein(a)

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine

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