Association Between Elevated Lipoprotein(a) and Diastolic Dysfunction: A Retrospective Cohort Study.

INTRODUCTION

Lipoprotein(a) [Lp(a)] has been linked to myocardial fibrosis and endothelial dysfunction, proposed mechanisms for diastolic dysfunction (DD). This study assessed the association between elevated Lp(a) (≥ 50 mg/dL) and DD in patients with preserved ejection fraction (EF).

AIM: We analyzed 1492 adults (median age59) with an Lp(a) measurement and echocardiogram (1997-2024).

METHODS

Diastolicdysfunction required ≥ 3 abnormal echo parameters, as per recent guidelines. Logisticregression adjusting for potential confounders was performed.

RESULTS

Seventy-sevenpatients (5.1%) had DD. Lp(a) ≥ 50 mg/dL was not associated with DD [adjusted oddsratio (aOR): 0.89, 95% confidence interval (CI): 0.49-1.54]. However, age (aOR:1.03, p = 0.026), hypertension (aOR: 1.83, p = 0.042), diabetes mellitus (aOR: 2.43, p =0.002), and cardiovascular (CV) diseases (aOR: 1.90, p = 0.043) were associated withDD, while statin therapy was associated with reduced risk (aOR: 0.51, p = 0.016).

CONCLUSIONS

In the setting of preserved EF, Lp(a) was not associated with DD,emphasizing management of traditional CV risks.