Evidence map›Paper›PMID 39607751›Full record

ArticleEuropean journal of preventive cardiology2025

Traditional risk factors, optimal cardiovascular health, and elevated lipoprotein(a).

Alexander C Razavi, Mikaila P Reyes, John T Wilkins, Moyses S Szklo, Michael Y Tsai, Seamus P Whelton, Laurence S Sperling, Sotirios Tsimikas, Harpreet S Bhatia

Abstract readMulticenter Study
In one paragraph

Article in European journal of preventive cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Lowering of Lipoprotein(a) with Olpasiran.Cardiovascular & hematological disorders drug targets · 2026
    Review
  3. Review
  4. Lipoprotein (a) in primary cardiovascular disease prevention is actionable today.American heart journal plus : cardiology research and practice · 2025
    Review
  5. Review
  6. Lipoprotein(a) at a "Tipping Point": case to move to universal screening.American journal of preventive cardiology · 2025
    Review
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Alexander C RazaviEmory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA.ORCID 0000-0002-3213-0876
Mikaila P ReyesSchool of Medicine, University of California San Diego, La Jolla, CA, USA.
John T WilkinsDivision of Cardiology, Department of Medicine, Northwestern Feinberg School of Medicine, Chicago, IL, USA.
Moyses S SzkloDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Michael Y TsaiDepartment of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.ORCID 0000-0001-7553-3408
Seamus P WheltonCiccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Laurence S SperlingEmory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA.
Sotirios TsimikasDivision of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California San Diego, 9500 Gilman Drive, MC 7411, La Jolla, CA 92093, USA.
Harpreet S BhatiaDivision of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California San Diego, 9500 Gilman Drive, MC 7411, La Jolla, CA 92093, USA.ORCID 0000-0002-3964-2989

Funding

Institute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1M
Wake Forest Clinical and Translational Science AwardUL1TR001420 · NCATS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ARD, JAMY D, FOLEY, KRISTIE L · 2015 to 2023
$32.3M
Clinical and Translational Science AwardUL1TR000040 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015
$26.2M
Task Area A Core Study Operations.Task Area A shall encompass annual follow-up of cohort members, clinical endpoints ascertainment, study coordination activities, maintenance of the database and biosp75N92020D00001 · NHLBI · UNIVERSITY OF WASHINGTON · PI MCCLELLAND, ROBYN LEAGH · 2020 to 2025
$17.2M
Task Area A shall encompass annual follow-up of cohort members, clinical events investigations, study operations, and data analysis and manuscript writing. If implemented, Task A.1 will provide fundin75N92020D00005 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI WATSON, KAROL E · 2020 to 2025
$5.1M
TO EXERCISE OPTION PERIOD ONE (1) FOR TASK AREA A - MESA CORE OPERATIONS, FIELD CENTER.75N92020D00004 · NHLBI · NORTHWESTERN UNIVERSITY · PI SIEGEL, JONATHAN H · 2020 to 2025
$4.5M
Task Area A shall encompass annual follow-up of cohort members, clinical events investigations, study operations, and data analysis and manuscript writing. If implemented, Task A.1 will provide fundin75N92020D00006 · NHLBI · UNIVERSITY OF MINNESOTA · PI PANKOW, JAMES S · 2020 to 2025
$4.4M
Task Area A shall encompass annual follow-up of cohort members, clinical events investigations, study operations, and data analysis and manuscript writing. If implemented, Task A.1 will provide fundin75N92020D00003 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI POST, WENDY S · 2020 to 2025
$3.8M
Task Area A shall encompass annual follow-up of cohort members, clinical events investigations, study operations, and data analysis and manuscript writing. If implemented, Task A.1 will provide fundin75N92020D00007 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI BERTONI, ALAIN GERALD · 2020 to 2025
$3.5M
Task Area A shall encompass annual follow-up of cohort members, clinical events investigations, study operations, and data analysis and manuscript writing. If implemented, Task A.1 will provide fundin75N92020D00002 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHEA, STEVEN J · 2020 to 2025
$3.4M
Translating Lp(a) biology to clinical applicationsR01HL159156 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SOTIRIOS TSIMIKAS · 2022 to 2026
$3.3M
Aspirin, Lp(a) and Primary Prevention of Cardiovascular EventsR01HL170224 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SOTIRIOS TSIMIKAS · 2023 to 2026
$3.0M
NCATSNCATS NIH HHS UL1 TR000040NCATS NIH HHS UL1 TR001079NCATS NIH HHS UL1 TR001420NHLBI NIH HHS 75N92020D00001NHLBI NIH HHS 75N92020D00002NHLBI NIH HHS 75N92020D00003NHLBI NIH HHS 75N92020D00004NHLBI NIH HHS 75N92020D00005NHLBI NIH HHS 75N92020D00006NHLBI NIH HHS 75N92020D00007NHLBI NIH HHS F32 HL172499NHLBI NIH HHS HHSN268201500003CNHLBI NIH HHS HHSN268201500003INHLBI NIH HHS HL170224NHLBI NIH HHS K08 HL166962NHLBI NIH HHS L30 HL175751NHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095160NHLBI NIH HHS N01 HC095161NHLBI NIH HHS N01 HC095162NHLBI NIH HHS N01 HC095163NHLBI NIH HHS N01 HC095164NHLBI NIH HHS N01 HC095165NHLBI NIH HHS N01 HC095166NHLBI NIH HHS N01 HC095167NHLBI NIH HHS N01 HC095168NHLBI NIH HHS N01 HC095169NHLBI NIH HHS R01 HL159156NHLBI NIH HHS R01 HL170224NHLBI NIH HHS UL1-TR-000040, UL1-TR-001079NHLBI NIH HHS UL1-TR-001420NIHNIH HHS 1K08HL166962NIH HHS 75N92020D00001NIH HHS 75N92020D00005NIH HHS F32HL172499NIH HHS HHSN268201500003INIH HHS L30HL175751NIH HHS N01-HC-95159NIH HHS N01-HC-95160, 75N92020D00002, N01-HC-95161, 75N92020D00003, N01-HC-95162, 75N92020D00006, N01-HC-95163, 75N92020D00004, N01-HC-95164, 75N92020D00007, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168NIH HHS N01-HC-95169U.S. Department of Health and Human Services
6 · The paper itself

Abstract

aimsTo assess the association of traditional risk factor burden and Life's Simple 7 (LS7) score with incident atherosclerotic cardiovascular disease (ASCVD) across lipoprotein(a) [Lp(a)] levels. METHODS AND

resultsThere were 6676 participants without clinical ASCVD from the Multi-Ethnic Study of Atherosclerosis who underwent Lp(a) testing and were followed for incident ASCVD events (coronary heart disease and stroke). Low, intermediate, and elevated Lp(a) were defined as <30, 30-49, and ≥50 mg/dL, respectively. Cox proportional hazards regression assessed the association of traditional risk factors and LS7 score (poor: 0-8, average: 9-10, and optimal: 11-14) with incident ASCVD across Lp(a) groups during a median follow-up of 17.7 years, adjusting for demographics and time-varying statin and aspirin therapy. The mean age was 62.1 years, 53% were women, and 61% were non-white. The median Lp(a) was 17 (interquartile range 8-41) mg/dL, 13% had Lp(a) 30-49 mg/dL, and 20% had Lp(a) ≥ 50 mg/dL. Individuals with Lp(a) ≥ 50 mg/dL had higher absolute event rates across all LS7 categories. There was no significant interaction between Lp(a) and LS7 score on incident ASCVD (P-interaction = 0.60). Compared to a poor LS7 score, optimal LS7 conferred a lower risk for incident ASCVD among individuals with Lp(a) < 30 [hazard ratio (HR) = 0.45, 95% confidence interval (CI): 0.28-0.71], Lp(a) 30-49 (HR = 0.12, 95% CI: 0.02-0.89), and Lp(a) ≥ 50 mg/dL (HR = 0.35, 95% CI: 0.13-0.99).

conclusionParticipants without clinical ASCVD who achieved an optimal LS7 score had ASCVD risk reduction regardless of Lp(a) level. These results emphasize the importance of a healthy lifestyle and ASCVD risk factor control among individuals with elevated Lp(a).

Indexed as

AtherosclerosisLipoprotein(a)AgedBiomarkersFemaleHeart Disease Risk FactorsHumansIncidenceMaleMiddle AgedPrognosisProspective StudiesRisk AssessmentRisk FactorsTime FactorsUnited StatesBiomarkersLipoprotein(a)LPA protein, humanAmerican Heart AssociationCardiovascular diseaseCholesterolLifestyleLipoprotein(a)Prevention

Identifiers

PMID39607751
PMCPMC12172025

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.