What is the relationship between lipoprotein(a) (Lp[a]) concentration and the risk of major vascular and nonvascular outcomes?
JAMA · 2009 · PMID 19622820 · DOI 10.1001/jama.2009.1063
Higher lipoprotein(a) levels are modestly and independently associated with an increased risk of coronary heart disease and stroke, but not with nonvascular deaths.
The question
What is the relationship between lipoprotein(a) (Lp[a]) concentration and the risk of major vascular and nonvascular outcomes?
What they tested
Circulating concentration of lipoprotein(a) (Lp[a]) may be associated with an increased risk of coronary heart disease (CHD) and stroke.
How they did it
This study identified 36 long-term prospective studies published between January 1970 and March 2009 that recorded Lp(a) concentration and subsequent major vascular morbidity and/or cause-specific mortality. Individual records for 126,634 participants were analyzed, excluding those with preexisting CHD or stroke at baseline. Within-study regression analyses, adjusted for within-person variation, were combined using meta-analysis.
What they found
During 1.3 million person-years of follow-up, 22,076 first-ever fatal or nonfatal vascular disease outcomes or nonvascular deaths were recorded. Lp(a) concentration showed weak correlation with conventional vascular risk factors and was highly consistent within individuals over several years. The rates of CHD in the top and bottom thirds of baseline Lp(a) distributions were 5.6 and 4.4 per 1000 person-years, respectively. The risk ratio for CHD was 1.16 per 3.5-fold higher usual Lp(a) concentration (adjusted for age and sex) and 1.13 after further adjustment for other risk factors. The adjusted risk ratio for ischemic stroke was 1.10, while for nonvascular mortality, cancer deaths, and nonvascular deaths other than cancer, the risk ratios were 1.01, 1.00, and 1.00, respectively.
| Bottom Third Lp(a) | 4.4 | |
|---|---|---|
| Top Third Lp(a) | 5.6 |
Rates of coronary heart disease (CHD) per 1000 person-years in participants categorized by their baseline Lp(a) concentration thirds.
What it means
Lp(a) concentration has continuous, independent, and modest associations with the risk of coronary heart disease and stroke, and these associations appear to be exclusive to vascular outcomes.
Limitations
The abstract does not explicitly state limitations of the study.
Where the published abstract does not list limitations, we say so rather than inventing them. Read the full paper on PubMed before drawing conclusions.
The paper at a glance
| Magellan’s evidence label | Lipoprotein(a) concentration (our label for this citation — see PubMed for the paper’s own title and authors) |
|---|---|
| Journal | JAMA |
| Year | 2009 |
| PMID | 19622820 ↗ |
| DOI | 10.1001/jama.2009.1063 ↗ |
| Topic | General aging biology & healthspan |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
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Lp(a) Mail-In Test
Large meta-analyses, prospective cohorts, and Mendelian randomization studies establish elevated Lp(a) as a causal, independent risk factor for coronary heart disease, myocardial infarction, ischemic stroke, peripheral artery disease, and calcific aortic valve stenosis, with roughly one in five people carrying high…
Lipoprotein(a), or Lp(a), is a low-density lipoprotein (LDL)-like particle in which an…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). What is the relationship between lipoprotein(a) (Lp[a]) concentration and the risk of major vascular and nonvascular outcomes? [Plain-English summary of JAMA 2009, PMID 19622820, DOI 10.1001/jama.2009.1063]. Magellan Longevity. https://magellanlongevity.com/study/s141.html@misc{magellan_s141,
title = {What is the relationship between lipoprotein(a) (Lp[a]) concentration and the risk of major vascular and nonvascular outcomes?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/s141.html}},
note = {Plain-English summary of PubMed PMID 19622820; DOI 10.1001/jama.2009.1063; JAMA 2009. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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