ArticleLipids in health and disease2025
Cardiovascular endpoints and psychosocial challenges of lipoprotein(a) of 5726 participants in the ELITE-study over 5 years.
Article in Lipids in health and disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Lipoprotein(a) in cardiovascular disease: pathophysiology, residual risk, and emerging therapeutic strategies.Frontiers in medicine · 2026Review
- Lipoprotein(a): A Novel Risk Factor for Heart Failure and Biomarker of Prognosis? From Pathophysiology to Clinical Practice.Cardiac failure review · 2026Review
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9 authors.
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Abstract
backgroundLipoprotein(a) [Lp(a)] is a known independent risk factor for cardiovascular disease, yet awareness and management remain limited. The psychosocial implications of elevated Lp(a)-levels have been poorly characterized.
objectivesTo compare cardiovascular outcomes and cardiovascular risk factor (CVRF) modification in individuals with normal vs. elevated Lp(a) levels, and to assess the impact of individualized prevention recommendations. For the first time, the individual psychological stress caused by Lp(a) is being surveyed.
methodsThe ELITE study is a prospective, interventional cohort study conducted in north-western Germany. Participants were regularly assessed for CVRFs, including Lp(a), hypertension, dyslipidemia, diabetes mellitus, weight, nicotine - as well as lipoprotein (a), physical activity, dietary habits, depression and stress. They received written, personalized prevention recommendations. Follow-up averaged 4.4 years. Two groups were analyzed: Group 1 (Gr1, n=3,241) with normal Lp(a), and Group 2 (Gr2, n=841) with elevated Lp(a ≥75 nmol/l).
resultsGr2 (mean Lp(a) 154.8 nmol/l) and Gr1 (mean Lp(a) 16.4 nmol/l) were comparable in age (~53 years) and sex distribution (~49% female). Most participants with elevated Lp(a) were previously unaware of their levels; 30% were referred to specialists, and ~40% reported concern or anxiety. Combined cardiovascular endpoints (CHD, stroke, heart failure, PAD, carotid stenosis, AF) occurred significantly more often in Gr2 (p<0.001), despite similar CVRF profiles, except for higher baseline LDL-C in Gr2 (p<0.001). Hypertension (61%) and physical inactivity (57%) were the most prevalent CVRFs. Personalized prevention measures led to significant improvements in blood pressure, LDL-C, smoking, physical activity, and weight in both groups. Lipid-lowering therapy improved markedly in Gr2 (12% to 23%).
conclusionsElevated Lp(a) is associated with a significantly higher rate of cardiovascular events, independent of traditional CVRFs. This confirms a causal role of Lp(a) in CV morbidity. Personalized written prevention recommendations improved CVRFs across both groups, though further optimization is needed. Notably, elevated Lp(a) also imposes a psychosocial burden, underlining the need for enhanced education, counseling, and clinical pathways.
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