# Advantages of using Genetically Elevated Lipoprotein(a) Levels in Predicting 5-Year Major Adverse Cardiovascular Events Relating to Coronary Artery Disease in Women

## TL;DR

This study found that elevated lipoprotein(a) levels and KIV-2 repeat numbers in the LPA gene predict cardiovascular risks in women with coronary artery disease.

## Contribution

The study introduces a more accurate method for predicting cardiovascular events in women using genetic markers in the LPA gene.

## Key findings

- Elevated lipoprotein(a) levels significantly increase MACE risk in men but not in women.
- KIV-2 repeat copy number quantification improves MACE prediction in women with CAD.
- Lipoprotein(a) levels inversely correlate with KIV-2 repeat numbers.

## Abstract

This study aimed to investigate major adverse cardiovascular
events (MACE) in patients with coronary artery disease (CAD) over 5 years, in
general, and depending on sex, lipoprotein(a) level, and number of kringle IV
type 2 (KIV-2) repeats in the Lipoprotein(A) (LPA) gene.

This
study comprised 216 patients (120 women and 96 men) hospitalized with a diagnosis
of “CAD, unstable angina IIB class”. The three-point risk of MACEs was
assessed over 5 years: cardiovascular death, non-fatal myocardial infarction, and
stroke. The number of KIV-2 repeats in the LPA gene was determined by
quantitative real-time polymerase chain reaction (qPCR).

The relative risk of MACE in
patients with elevated lipoprotein(a) (Lp(a)) was 2.0 (95% CI 1.04–3.87,
p
< 0.05) for quartile 4 (Q4) ≥48 mg/dL versus quartile 1 (Q1)
≤6 mg/dL. This was mainly attributable to an increase in men—relative risk (RR) 2.6
(95% CI 1.10–6.16, p
< 0.05)—but not in women: RR 1.4 (95% CI
0.50–3.92). Mean lipoprotein(a) levels were inversely correlated with 42.5 and
7.5 for Q1 and Q4 KIV-2 repeat numbers, respectively. The relative risks of MACE
for Q1 vs. Q4 KIV-2 repeats were as follows: 3.0 (95% CI 1.48–6.08, p
< 0.001) for all patients; 3.0 (95% CI 1.20–6.55, p
< 0.01) for
men; 3.3 (95% CI 1.02–10.4, p
< 0.05) for women.

Quantifying kringle IV type 2 repeat copy number in the LPA
gene using qPCR more accurately reflects the risk of major adverse cardiovascular
events within 5 years in women with coronary artery disease.