Circulating lipoprotein (a) and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis

作者：Mojgan Amiri, Hamidreza Raeisi‐Dehkordi, Auke J.C.F. Verkaar, YAHONG WU, Anniek C. van Westing, Kirsten A. Berk, Wichor M. Bramer, Dagfinn Aune, Trudy Voortman · 发表于：European Journal of Epidemiology · 年份：2023 · DOI：10.1007/s10654-022-00956-4 · 被引用次数：57 · 研究领域：Lipoproteins and Cardiovascular Health、Diabetes, Cardiovascular Risks, and Lipoproteins、Antiplatelet Therapy and Cardiovascular Diseases

Abstract Aims To investigate the association between circulating lipoprotein(a) (Lp(a)) and risk of all-cause and cause-specific mortality in the general population and in patients with chronic diseases, and to elucidate the dose-response relations. Methods and results We searched literature to find prospective studies reporting adjusted risk estimates on the association of Lp(a) and mortality outcomes. Forty-three publications, reporting on 75 studies (957,253 participants), were included. The hazard ratios (HRs) and 95% confidence intervals (95%CI ) for the top versus bottom tertile of Lp(a) levels and risk of all-cause mortality were 1.09 (95%CI: 1.01–1.18, I 2 : 75.34%, n = 19) in the general population and 1.18 (95%CI: 1.04–1.34, I 2 : 52.5%, n = 12) in patients with cardiovascular diseases (CVD). The HRs for CVD mortality were 1.33 (95%CI: 1.11–1.58, I 2 : 82.8%, n = 31) in the general population, 1.25 (95%CI: 1.10–1.43, I 2 : 54.3%, n = 17) in patients with CVD and 2.53 (95%CI: 1.13–5.64, I 2 : 66%, n = 4) in patients with diabetes mellitus. Linear dose-response analyses revealed that each 50 mg/dL increase in Lp(a) levels was associated with 31% and 15% greater risk of CVD death in the general population and in patients with CVD. No non-linear dose-response association was observed between Lp(a) levels and risk of all-cause or CVD mortality in the general population or in patients with CVD (P nonlinearity > 0.05). Conclusion This study provides further evidence tha...