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.


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

Omega-3 Fatty Acids for Prevention of CVD, Cochrane Library; ePub 2018 Jul 18; Abdelhamid, et al

Elevated hs-CRP Among Patients with Prior MI, Am Heart J; ePub 2018 Jul 26; Pagidipati, et al

Catheter Ablation for Ventricular Arrhythmias, Am J Cardiol; ePub 2018 Jul 18; Ogunbayo, et al

PIs and CV Outcomes in Patients with HIV and HF, J Am Coll Cardiol; 2018 Jul; Alvi, Neilan, et al

Hypertension in Blacks Higher Through Middle Age, J Am Heart Assoc; ePub 2018 Jul 11; Thomas, et al

Must Reads in Hypercholesterolemia

Racial Differences in Statin Use, JAMA Cardiol; ePub 2018 Jun 13; Nanna, et al

LLT Use in Patients with Elevated LDL-C, Circ Cardiovasc Qual Outcomes; ePub 2018 May 10; Virani, et al

Evolocumab in Differing Patient Populations , J Pharmacokinet Pharmacodyn; ePub 2018 May 7; Kuchimanchi, et al

LDL-C Targets in Elderly Statin Users After ACS, J Am Heart Assoc; ePub 2018 May 12; Alter, et al

Patient Perspectives on Statin Therapy, Clin Cardiol; ePub 2018 May 10; Brinton