Patients with well-controlled low-density lipoprotein cholesterol (LDL-C) levels still suffer from the progress of the atherosclerotic cardiovascular disease (ASCVD) and can develop adverse outcomes. We conducted this study to analyze the relationship between elevated lipoprotein(a) [Lp(a)] levels and ASCVD risk. We enrolled 8070 patients in the ASCVD group and 440 participants in the non-ASCVD group [median age of 60 years; 6376 (74.9%) were male]. Multivariate logistic regression models were used to identify the relationships between the lipids and ASCVD. These models showed that the Lp(a) level was a significant independent risk factor for ASCVD [odds ratio (OR) = 1.025, confidence interval (CI) = 1.020–1.029, P < .001]. The different categories analysis showed the OR of the high Lp(a)/low LDL-C group was 9.612 [CI = 6.206–14.887], P < .001. Our study demonstrated that elevated Lp(a) levels were associated with the increased ASCVD risk. Also, the patients with low LDL-C but high Lp(a) levels still had a higher risk of developing ASCVD than the low Lp(a)/high LDL-C group. In addition, elevated Lp(a) levels were associated with a higher ASCVD risk in males, hypertensive, and diabetic patients.

中文翻译：

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血浆脂蛋白（a）水平升高与动脉粥样硬化性心血管疾病风险：一项大型临床回顾性研究

低密度脂蛋白胆固醇 (LDL-C) 水平得到良好控制的患者仍会遭受动脉粥样硬化性心血管疾病 (ASCVD) 的进展，并可能出现不良后果。我们进行这项研究是为了分析脂蛋白(a) [Lp(a)] 水平升高与 ASCVD 风险之间的关系。我们招募了 8070 名 ASCVD 组患者和 440 名非 ASCVD 组参与者[中位年龄 60 岁；6376 名（74.9%）为男性]。使用多变量逻辑回归模型来确定血脂与 ASCVD 之间的关系。这些模型表明，Lp(a) 水平是 ASCVD 的一个显着的独立危险因素 [比值比 (OR) = 1.025，置信区间 (CI) = 1.020–1.029，P < .001]。不同类别分析显示高 Lp(a)/低 LDL-C 组的 OR 为 9.612 [CI = 6.206–14.887]，P < .001。我们的研究表明，Lp(a) 水平升高与 ASCVD 风险增加相关。此外，低LDL-C但高Lp(a)水平的患者发生ASCVD的风险仍高于低Lp(a)/高LDL-C组。此外，Lp(a) 水平升高与男性、高血压和糖尿病患者较高的 ASCVD 风险相关。