# Clinical Relevance of Lipoprotein(a) in Young Acute Myocardial Infarction: STEMI vs. NSTEMI

## TL;DR

High levels of Lp(a) are linked to heart disease in young people, especially those with NSTEMI heart attacks.

## Contribution

The study identifies Lp(a) as a significant biomarker for multivessel disease in young NSTEMI patients.

## Key findings

- Elevated Lp(a) levels are significantly more common in young AMI patients than in healthy controls.
- High Lp(a) is strongly associated with multivessel coronary disease in NSTEMI cases.
- Lp(a)'s impact in STEMI is weaker and influenced by other factors like diabetes and LDL cholesterol.

## Abstract

Background: The incidence of acute myocardial infarction (AMI) in young adults has been steadily rising, emphasizing the need for new biomarkers to improve risk stratification. Lipoprotein(a) (Lp(a)), a genetically determined lipoprotein with pro-atherogenic and pro-thrombotic properties, has gained increasing attention in this context. Methods: We evaluated serum Lp(a) levels in young patients with AMI and compared them with healthy controls. Associations between elevated Lp(a) levels (≥30 mg/dL) and coronary artery disease patterns were analyzed separately for STEMI and NSTEMI presentations. Results: Elevated Lp(a) levels were significantly more common in young patients with AMI compared with healthy controls. Importantly, Lp(a) ≥ 30 mg/dL was strongly associated with multivessel coronary artery disease in NSTEMI, conferring more than a fourfold increased risk. In STEMI, the effect was weaker and largely influenced by concomitant factors such as diabetes and elevated LDL cholesterol. Conclusions: These findings highlight key pathophysiological differences between infarct phenotypes and position Lp(a) as a particularly relevant biomarker in young NSTEMI patients. The systematic assessment of Lp(a) may enhance coronary risk stratification and support more tailored secondary prevention strategies.