Country-specific prevalence and clinical relevance of elevated Lp(a) as a risk enhancer in 2 Greek cohorts
BACKGROUND - National epidemiologic data are needed to inform country-specific healthcare policies for prevention and new developing treatments. - OBJECTIVE - We aimed to analyze Greek epidemiologic data in clinically relevant special populations for targeted treatments and to evaluate the utility o...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
March 2026
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| In: |
Journal of clinical lipidology
Year: 2026, Volume: 20, Issue: 3, Pages: 609-619 |
| ISSN: | 1876-4789 |
| DOI: | 10.1016/j.jacl.2025.12.016 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.jacl.2025.12.016 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1933287425005495 
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| Author Notes: | Dimitrios Delialis, PhD1, Polyxeni Manifava, MD, Sofia-Panagiota Giannakopoulou, MSc, Christina Konstantaki, MD, Stavros Athanasopoulos, MD, Georgios Zervas, MD, Panagiotis Nastatos, MD, Georgios Mavraganis, MD, Kateryna Sopova, PhD, Maria-Angeliki Dimopoulou, MD, Lydia Kokkinidou, MD, Yannis Skoumas, PhD, Christos Pitsavos, PhD, Nikolaos Rachiotis, MD, Lasthenis Angelidakis, MD, Dimitrios Papoutsis, PhD, Peggy Kostakou, PhD, Elisabeth Samouilidou, MD, Achilleas A. Zacharoulis, MD, Konstantinos Stellos, PhD, Evangellos Liberopoulos, PhD, Christina Chrysochoou, PhD, Georgios Georgiopoulos, PhD, Demosthenes Panagiotakos, PhD, Kimon Stamatelopoulos, MD, PhD |
| Summary: | BACKGROUND - National epidemiologic data are needed to inform country-specific healthcare policies for prevention and new developing treatments. - OBJECTIVE - We aimed to analyze Greek epidemiologic data in clinically relevant special populations for targeted treatments and to evaluate the utility of lipoprotein(a) [Lp(a)] as a risk enhancer - METHODS - Two independent cohorts were included in this analysis: (1) consecutively recruited patients assessed in a tertiary outpatients’ lipid clinic (Athens Angiometabolic cohort [AAC], n = 1106) with available peripheral vascular markers, and (2) sample of the Greek general population (ATTICA study [AS], n = 2682) with available 20-year follow-up data for atherosclerotic cardiovascular disease (ASCVD) events. - RESULTS - Increased Lp(a) was found in 8.3% of the AS (≥50 mg/dL) and in 18.9% of the AAC (≥125 nmol/L) (16.0% without ASCVD and 22.1% with ASCVD, P = .006). Elevated Lp(a) levels were associated with increased carotid, coronary artery, and lower extremity atherosclerosis (P < .05 for all). Both the European Atherosclerosis Society (EAS) recommendations (net reclassification index [NRI]: 0.170) and a derived sex-specific inflation factor for HellenicSCOREII+ (NRI: 0.176) were efficient in incorporating Lp(a) as a risk enhancer over HellenicSCOREII+ for 20-year major adverse cardiovascular events. For 10-year cardiovascular death, only the EAS consensus provided significant reclassification. Finally, Lp(a) conferred increased eligibility for more aggressive primary prevention measures both by EAS recommendations (23.6% in AAC/13.6% in AS) and by sex-specific inflation factors (25.6% in AAC/22.3% in AS). - CONCLUSION - Elevated Lp(a) levels were observed in 8.3% of the general population cohort and up to 23.9% in participants with ASCVD from the lipid clinic cohort, highlighting a risk gradient across ASCVD categories. Incorporating Lp(a) as a risk enhancer improves ASCVD risk reclassification beyond the validated HellenicSCOREII+. |
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| Item Description: | Gesehen am 20.04.2026 Online verfügbar: 23. Dezember 2025, Artikelversion: 20. März 2026 |
| Physical Description: | Online Resource |
| ISSN: | 1876-4789 |
| DOI: | 10.1016/j.jacl.2025.12.016 |