Title:Lipoprotein (a) Levels and Abdominal Aortic Aneurysm. A Systematic Review
and Meta-analysis
Volume: 28
Issue: 43
Author(s): Stamatios Lampsas, Evangelos Oikonomou*, Panteleimon Pantelidis, Panagiotis Theofilis, Konstantinos Grammatopoulos, Anastasios Marathonitis, Michael A Vavuranakis, Gerasimos Siasos, Dimitris Tousoulis and Manolis Vavuranakis
Affiliation:
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital,
Athens, Greece
- Cardiometabolic Disease Unit, 3rd Department of Cardiology, National and Kapodistrian University of Athens,
Medical School, Sotiria Chest Disease Hospital, Athens, 11527 Greece
Keywords:
Lp(a), abdominal aortic aneurysm, biomarker, risk factor, atherosclerosis, aortic wall.
Abstract:
Background: Several studies have linked high Lipoprotein (a) (Lp(a)) concentrations to cardiovascular
events, including the formation of Abdominal Aortic Aneurysms (AAA). We review and meta-analyze existing
evidence on the association of Lp(a) levels with AAA.
Methods: Studies evaluating the link of Lp(a) with AAA, up to December 27th 2021, were identified by a systematic
search of PubMed, SCOPUS, and Web of Science databases. The results were qualitatively and quantitatively
synthesized according to PRISMA guidelines. Results are presented as standardized mean differences (SMD)
with 95% confidence intervals (CI).
Results: A total of 5,078 subjects (1,637 patients with AAA vs. 3,441 controls) from 11 studies were included
in the meta-analysis, with a mean age of 69.9 years and a male sex prevalence of 85.8%. Based on the qualitative
synthesis, high Lp(a) concentrations are linked to abdominal aortic wall degradation and extracellular matrix
disarrangement. Moreover, despite the considerable variability among races, high Lp(a) levels are related to
increased AAA risk, independently of race differences. Accordingly, patients with AAA displayed significantly
higher Lp(a) levels compared to controls (SMD: 0.86, 95% CI: 0.55-1.17, p < 0.001). The outcome was not affected
in a sensitivity analysis excluding three outlying studies (SMD: 0.40, 95% CI: 0.22-0.58, p < 0.001).
Conclusion: This meta-analysis indicates the association between high Lp(a) levels and the presence of AAA,
although existing literature presents high heterogeneity. Further studies are needed to standardize Lp(a) measurements
and to conclude whether Lp(a) can be used as a sensitive biomarker of early presymptomatic AAA
diagnosis.
