Lipoprotein(a) and its impact on cardiovascular disease – the Polish perspective: Design, and first results of the Zabrze-Lipoprotein(a) Registry

IntroductionLipoprotein(a) is an independent risk factor for ASCVD. An Lp(a) concentration >30 mg/dl may cause faster atherosclerosis, making it an essential residual cardiovascular risk factor. It is necessary to characterize the patients at risk for ASCVD with high Lp(a) levels.Material and methodsThe Zabrze-Lipoprotein(a) Registry was founded on the basis of data from 2,001 consecutive patients with very high cardiovascular risk treated in a tertiary hospital.ResultsThe mean age of patients was 66.4 years (females 37.1%). The median Lp(a) concentration in the entire population was 6.6 mg/dl (16.5 nmol/l) (mean 14.3±19.4 mg/dl). 540 (27%) patients had elevated Lp(a) levels above 30 mg/dl (75 nmol/l); they were significantly older (68.8 vs 66.3 years; p=0.04), had significantly lower haemoglobin and hematocrit, and higher platelet count and levels of NT-proBNP and CRP. The prevalence of elevated Lp(a) >30 mg/dL (75 nmol/l) concentrations was very high in patients with a chronic coronary syndrome (CCS) (52.2% [282/540] vs. 41.5% [607/1461]; p<0.001), in patients undergoing PCI during hospitalization (23.9 vs.19%; p=0.01), and in patients with previous MI (20.6 % vs. 14.9%; p=0.0022). In the multivariable analysis, the independent predictors of elevated Lp(a) >30 mg/dl (75 nmol/l) were only lower Hb values (OR 0.925; 95%CI: 0.874–0.978; p=0.006), and higher platelet count (1.002; 95%CI: 1.000-1.003; p<0.02).Conclusions27% of patients with very high cardiovascular risk in Poland have an additional risk related to an increase in Lp(a) level with even every second patient with CCS. Two factors were significantly related to elevated Lp(a) levels—lower Hb values and higher platelet count.