Lipoproteins predicting coronary lesion complexity in premature coronary artery disease: a supervised machine learning approach

Frontiers in Cardiovascular Medicine, Journal Year: 2025, Volume and Issue: 12

Published: April 24, 2025

Introduction We aimed to assess the usefulness of lipoprotein(a) [Lp(a)] and LDL-C levels as potential predictors coronary lesions' complexity in patients with premature artery disease (pCAD). Methods This study enrolled 162 consecutive pCAD undergoing angiography. The SYNTAX score (SS) was used complexity. Linear discriminant analysis (LDA) employed construct a multivariate classification model enabling prediction SS. Results Lp(a) among SS ≥ 23 1-22 were significantly higher than those = 0 ( p 0.021 0.027, respectively). cut-off point for level 63.5 mg/dl discriminated subjects from ≤ 22 (sensitivity 0.546, specificity 0.780; AUC 0.620; 0.027). An LDA-based involving level, age, sex provided improved discrimination performance 0.727, 0.733, 0.800; 0.0001). Conclusions are associated advancement lesions patients. can be identification 23. modelling using Lp(a), LDL-C, age gender may an applicable tool preliminary at risk more complex lesions.

Language: Английский

---

Lipoprotein(a) as a Stroke Biomarker: Pathophysiological Pathways and Therapeutic Implications

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(9), P. 2990 - 2990

Published: April 25, 2025

Lipoprotein(a) [Lp(a)] has attracted widespread interest as a potential biomarker for cerebrovascular diseases due to its genetically determined and stable plasma concentration throughout life. Lp(a) exhibits pro-atherogenic pro-thrombotic properties that contribute vascular pathology in both extracranial intracranial vessels. Elevated levels are strongly associated with large-artery atherosclerotic stroke, while data on role other ischemic subtypes hemorrhagic stroke remains limited inconsistent. Recent advances Lp(a)-lowering therapies, such antisense oligonucleotides RNA-based agents, have demonstrated significant efficacy reducing levels. These prompted increasing research into their application the prevention treatment of diseases, aiming determine whether reduction may translate reduced risk atherosclerosis. This narrative review summarizes current evidence association between focusing utility patient stratification. It also highlights existing knowledge gaps outlines directions future research, particularly understanding subtype-specific effects evaluating clinical benefits Lp(a)-targeted therapies.

Language: Английский

---

Lipoprotein(a) is a highly atherogenic lipoprotein: pathophysiological basis and clinical implications

Current Opinion in Cardiology, Journal Year: 2024, Volume and Issue: 39(6), P. 503 - 510

Published: Aug. 13, 2024

Purpose of review Lipoprotein(a) has been identified as a causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and aortic valve stenosis. However, reviewed here, there is ongoing debate to the key pathogenic features Lp(a) particles degree atherogenicity relative low-density lipoprotein (LDL). Recent findings Genetic analyses have revealed that on per-particle basis markedly (about six-fold) more atherogenic than LDL. Oxidized phospholipids carried found substantial pro-inflammatory properties triggering pathways may contribute atherogenesis. Whether strength association with ASCVD dependent inflammatory status matter current critical implementing intervention strategies. Contradictory reports continue appear, but most recent studies in large cohorts indicate relationship independent C-reactive protein level. Summary highly viable target significant proportion general population. Better understanding its enhanced important assessment interpreting trials.

Language: Английский

---

Prediction of 10-Year Cardiovascular Disease Risk, by Diabetes status and Lipoprotein-a levels; the HellenicSCORE II+

Hellenic Journal of Cardiology, Journal Year: 2023, Volume and Issue: 79, P. 3 - 14

Published: Nov. 1, 2023

The aim of this study was to develop an updated model predict10-year cardiovascular disease (CVD) risk for Greek adults, i.e., the HellenicSCORE II+, based on smoking, systolic blood pressure (SBP), total and High-Density-Lipoprotein-(HDL) cholesterol levels, stratified by age group, sex, history diabetes, Lipoprotein (Lp)-a levels. Individual CVD scores were calculated through logit-function models, using beta-coefficients derived from SCORE2. Attica Study data used calibration (3,042 participants, aged 45(14) years; 49.1% men). Discrimination ability II+ assessed C-index (range 0-1), adjusted competing risks. mean score 6.3% (95% Confidence Interval (CI) 5.9% 6.6%) men 3.7% CI 3.5% 4.0%) women (p<0.001), higher compared relevant SCORE2; 23.5% classified as low risk, 40.2% moderate 36.3% high whereas corresponding percentages 56.2%, 18.6% 25.2%. C-statistic index 0.88 0.79 men, when applied ATTICA data, suggesting very good accuracy. Stratified analysis Lp(a) levels led a 4% improvement in correct classification among participants with Lp(a). values than SCORE2, confirming that population is at moderate-to-high risk. Stratification may assist better identify individuals

Language: Английский

---

Prevalence of lipoprotein(a) measurement in patients with or at risk of cardiovascular disease

Journal of clinical lipidology, Journal Year: 2023, Volume and Issue: 17(6), P. 748 - 755

Published: Oct. 4, 2023

Language: Английский

---