High CAC, high cholesterol increase heart attack/stroke risk,
cardiologists find

Date:
February 23, 2022
Source:
UT Southwestern Medical Center
Summary:
Patients with both a high lipoprotein(a) and high coronary artery
calcium score (CAC) face a more than 20% risk of heart attack or
stroke over the following 10 years, according to findings from a
multicenter study led by preventive cardiologists.



FULL STORY ========================================================================== Patients with both a high lipoprotein(a) and high coronary artery calcium
score (CAC) face a more than 20% risk of heart attack or stroke over
the following 10 years, according to findings from a multicenter study
led by preventive cardiologists at UT Southwestern Medical Center.


==========================================================================
"We are hopeful that by making the connection between Lp(a) and CAC
as dual risk drivers, we can raise awareness in the medical community
and improve earlier heart attack prevention for these patients," said cardiologist Parag Joshi, M.D., Associate Professor of Internal Medicine
at UT Southwestern.

"Our data may also expedite the development of treatments designed
specifically for this high-risk population," said Dr. Joshi, a member
of the Clinical Heart and Vascular Center at UT Southwestern.

Approximately one in six people in the U.S. have high Lp(a), a type of
bad cholesterol whose levels are driven largely by one's genes. Coronary
artery calcium, known as CAC, is a marker of plaque deposits around
the heart.

The team of researchers, which included researchers from Emory University, found that participants with combined high Lp(a) and high CAC had a 22%
10-year risk of heart attack or stroke, compared with a 10-15% 10-year
risk in patients who had either risk factor alone.

Investigators identified three distinct risk-related trends:
* High Lp(a), high CAC: These individuals face the highest 10-year
risk of
heart attack or stroke.

* High Lp(a), zero CAC: 10-year heart attack and stroke risk is
low when
there is no CAC, even if Lp(a) is high.

* Low Lp(a), high CAC: 10-year heart attack or stroke risk is
higher than
average but lower than with high LP(a) and high CAC combined.

The findings are online in the Journal of the American College of
Cardiology (JACC) and will appear in the March print edition. Read more
at "What Can Lp(a) Add to CAC for ASCVD Risk Prediction? New Insights"
at TMTMD.

"Establishing the connection between Lp(a) and CAC means we can move
to the important next phase of research, which will be defining and personalizing early screening protocols to identify patients at high risk
of heart attack," said Dr. Joshi, whose research focuses on assessing
risk for heart attack and stroke, CAC, cholesterol, and coronary CT angiography. "With further research, this could mean selectively scanning patients with high Lp(a) for their CAC score, and studying therapies specifically designed to reduce Lp(a) among patients with high CAC."
Cardiology researchers confirmed the Lp(a) and CAC connection by comparing
data from two landmark cardiovascular trials:
* The Dallas Heart Study, an ongoing comprehensive study of 6,000
diverse
and heart-healthy patients conducted by UT Southwestern from 2000
to present
* Multi-Ethnic Study of Atherosclerosis (MESA): A 6,000-participant
study
investigating early-stage atherosclerosis (hardening of the
arteries).

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========================================================================== Journal Reference:
1. Anurag Mehta, Nestor Vasquez, Colby R. Ayers, Jaideep Patel, Ananya
Hooda, Amit Khera, Roger S. Blumenthal, Michael D. Shapiro,
Carlos J.

Rodriguez, Michael Y. Tsai, Laurence S. Sperling, Salim S. Virani,
Michael J. Blaha, Parag H. Joshi. Independent Association
of Lipoprotein (a) and Coronary Artery Calcification With
Atherosclerotic Cardiovascular Risk. Journal of the American College
of Cardiology, 2022; 79 (8): 757 DOI: 10.1016/j.jacc.2021.11.058 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/02/220223153349.htm

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