Elevated lipoprotein(a) associated with carotid plaque and stenosis in Suita Study

The prospective Suita Study examined associations between lipoprotein(a) [Lp(a)] and carotid atherosclerosis in 3,272 Japanese adults without cardiovascular disease or carotid plaque at baseline. Participants had a mean age of 58.0 years, and 57.9% were women. Baseline assessments occurred in 1995–2004, with biennial carotid ultrasonography through June 2016. Incident plaque was defined as maximal carotid intima–media thickness (IMT) ≥1.7 mm; progression to stenosis was defined as ≥50% narrowing among participants who developed plaque.

Over a median 11.5 years, 1,432 participants developed plaques. Compared with Lp(a) <15 mg/dL, levels ≥50 mg/dL were associated with a multivariable-adjusted hazard ratio of 1.27 for incident plaque (95% CI, 1.01–1.61). The higher Lp(a) group also had faster annual maximal IMT progression (β=0.014 mm/year; 95% CI, 0.003–0.025). High Lp(a) was associated with progression to ≥50% stenosis, with an adjusted odds ratio of 2.29 (95% CI, 1.15–4.57).

These findings support an association between elevated Lp(a) and the development and progression of carotid atherosclerosis. However, this observational study does not establish causality or demonstrate that Lp(a) screening or targeted treatment improves clinical outcomes. The reported endpoints were imaging-based, and applicability beyond the Japanese study population remains uncertain. Only the abstract was available for assessment.