A recent study finds an unexepcted association between the CVD biomarker lipoprotein(a), atrial fibrillation, and stroke.
ARIC Study: Analysis of Lp(a) and Incident AF. Atherosclerosis Risk in Communities; biracial (black, white) community-based study in the US measured baseline Lp(a) levels and compared incident AF, ischemic stroke across Lp(a) levels.
High Lp(a) Not Linked to New AF. Lp(a) not linked to incidence AF; results not affected by race or sex.
High Lp(a) Linked to Ischemic Stroke in Patients without AF. High Lp(a) not linked to increased ischemic stroke risk in patients with prevalent AF.
Clinical Implications: The risk of stroke conferred by high Lp(a) is about 10 times lower than the risk of stroke due to AF; the link between high Lp(a) and ischemic stroke may be driven by atherosclerotic not cardioembolic stroke.
Lipoprotein(a) (Lp[a]) has drawn increasing attention as a valuable indicator of risk for cardiovascular disease. It is both proatherosclerotic and prothrombotic and is causally linked to CHD in Mendelian randomization studies. Outside of atherosclerosis and atherothrombosis, Lp(a) is also associated with calcific aortic stenosis. While limited research suggests that Lp(A) levels are not associated with atrial fibrillation (AF), the biomarker's role as an independent risk factor for AfF remains unclear.The slides above highlight a study designed to evaulate the prospective relationship between Lp(a) and incident AF andÂ associations of Lp(a) levels and stroke in persons with or without AF.Â References 1. Virani SS, Brautbar A, Davis BC, et al. Associations between lipoprotein(a) levels and cardiovascular outcomes in black and white subjects: the Atherosclerosis Risk in Communities (ARIC) Study. Circulation. 2012;125:241â249.2. 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. J Am Heart Assoc. 2017;6. pii: e007372. doi: 10.1161/JAHA.117.007372.