Abstract 4139408: Lipoprotein(a) levels in Polish population based on the STAR-Lp(a) cohort study. Prevalence, patient’s population, and risk factors.

Background: Elevated Lipoprotein(a) [Lp(a)] is independently associated with increased cardiovascular disease (CVD) risk. Purpose: The study aimed to evaluate the Lp(a) levels in Polish population and determine the association between socio-demographic and health-related variables and elevated Lp(a). Methods: The analysis was conducted among 2475 outpatient primary prevention patients (69.7% - women). The median age was 66.0 years ±20 years. Lp(a) levels were assessed in groups: <30 mg/dL (<75 nmol/l) (normal level) and >30 mg/dL (75-125 nmol/l) (elevated level). Statistical analysis was performed using STATISTICA 13.1. Qualitative variables were analyzed using descriptive statistics. The chi-square test was used to assess the relationship between quantitative variables. The Mann-Whitney test was used in the case of qualitative. Pearson's correlation coefficient was used to measure correlation. Multivariate logistic regression models were built to determine the effect of factors on the probability of elevated Lp(a) level. P<0.05 was judged as significant. Results: Lp(a) >30 mg/dL was recorded in 21.5% of patients (Fig. 1). The average age of patients with Lp(a)>30 was significantly higher (67 years ±17 vs. 65 years ± 20; p=0.008). A significant relationship was observed between the level of Lp(a) and the presence of selected comorbidities, i.e., hypertension, hyperlipidemia and atrial fibrillation (AF). The share of people with these disorders was higher in patients with elevated Lp(a) by 5.8; 6.6 and 1.7 pp. respectively. People suffering from migraines less frequently had Lp(a)>30 (5.6% vs 8.6%, p=0.025). Among patients with elevated Lp(a), there were significantly higher average levels of total cholesterol (TC), LDL cholesterol, non-HDL cholesterol, and hemoglobin A1C (HbA1C) (p=0.003; p=0.0004, p=0.003, p=0.021). A positive significant correlation was observed between the Lp(a) and the glucose level, both in patients with elevated Lp(a) level (r=0.19, p<0.001) (Fig. 2A). An analogous relationship was noted for Lp(A) and HbA1C (r=0.24; p<0.001) (Fig. 2B). In the regression model the factors determining the presence of elevated Lp(a)>30 included: AF (OR 1.99; 95CI: 1.091-3.629), diagnosed hyperlipemia (OR =1.414; 95 CI – 1.084-1.843) HbA1C>8 (OR=1.180; 95CI – 1.028-1.355), TC>250 mg/dl (OR=1.005; 95CI: 1.003-1.008), migraine (OR=0.539; 95CI - 0.306-0.950). Conclusion: Assessment of Lp(a) may be useful in taking effective management to reduce CVD risk.