Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Lipoprotein(a) Levels and Incident AF & Stroke

J Am Heart Assoc; ePub 2017 Dec 15; Aronis, et al

High lipoprotein(a) (Lp[a]) levels were not associated with incident atrial fibrillation (AF) but were associated with increased ischemic stroke risk, primary among individuals without AF but not in those with AF. This according to results from the ARIC (Atherosclerosis Risk in Communities) study cohort in which Lp(a) levels were measured at visit 4 (1996-1998). Incident AF was first evaluated in 9,908 participants free of AF at baseline. Researchers then evaluated ischemic stroke in 10,127 participants free of stroke at baseline. Baseline age was 62.7±5.6 years. Median Lp(a) levels were 13.3 mg/dL and median follow-up was 13.9 years and 15.8 years for AF and stroke, respectively. Among the findings:

  • Lp(a) was not associated with incident AF (HR, 0.98), comparing those with Lp(a) ≥50 with those with Lp(a) <10 mg/dL.
  • High Lp(a) was associated with a 42% relative increase in stroke risk among those without AF (HR, 1.42), but not in those with AF (HR, 1.06).
  • There were no interactions by race or sex.

Citation:

Aronis KN, Zhao D, Hoogeveen RC, et al. Associations of lipoprotein(a) levels with incident atrial fibrillation and ischemic stroke: The ARIC (Atherosclerosis Risk in Communities) study. [Published online ahead of print December 15, 2017]. J Am Heart Assoc. doi:10.1161/JAHA.117.007372.

This Week's Must Reads

Improving CV Health in Women Through Provider Collaboration, Circulation; ePub 2018 May 10; Brown, et al

Burden of AF With Risk of Stroke in Paroxysmal AF, JAMA Cardiol; ePub 2018 May 16; Go, et al

OSA & Risk of Hospitalization in Patients with HFpEF, Am J Cardiol; ePub 2018 May 11; Abdullah, et al

Air Pollution Exposure in Pregnancy & Risk of High BP, Hypertension; ePub 2018 May 14; Zhang, et al

Total & CV Mortality After LDL-C Lowering, JAMA; 2018 Apr 17; Navarese, et al

Must Reads in Hypercholesterolemia

Total & CV Mortality After LDL-C Lowering, JAMA; 2018 Apr 17; Navarese, et al

PCSK9 Inhibitors for Tx of Hypercholesterolemia, Ann Pharmacother; ePub 2018 Apr 1; Patel, et al

High-Intensity Statin Use and LDL-C Control, J Clin Lipidol; ePub 2018 Apr 26; Lamprecht Jr, et al

Improving Adherence with ASCVD Interventions, Clin Cardiol; ePub 2018 Apr 17; Fentanes, et al

Lipid Screening in Children with NAFLD, J Pediatr; ePub 2018 Apr 13; Harlow, et al