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Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess the association of traditional risk factor burden and Life\u2019s Simple 7 (LS7) score with incident atherosclerotic cardiovascular disease (ASCVD) across lipoprotein(a) [Lp(a)] levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>There 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 &amp;lt;30, 30\u201349, and \u226550\u2005mg\/dL, respectively. Cox proportional hazards regression assessed the association of traditional risk factors and LS7 score (poor: 0\u20138, average: 9\u201310, and optimal: 11\u201314) 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\u201341) mg\/dL, 13% had Lp(a) 30\u201349\u2005mg\/dL, and 20% had Lp(a) \u2265 50\u2005mg\/dL. Individuals with Lp(a) \u2265 50\u2005mg\/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) &amp;lt; 30 [hazard ratio (HR) = 0.45, 95% confidence interval (CI): 0.28\u20130.71], Lp(a) 30\u201349 (HR = 0.12, 95% CI: 0.02\u20130.89), and Lp(a) \u2265 50\u2005mg\/dL (HR = 0.35, 95% CI: 0.13\u20130.99).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Participants 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).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwae382","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T23:29:00Z","timestamp":1732577340000},"page":"724-732","source":"Crossref","is-referenced-by-count":18,"title":["Traditional risk factors, optimal cardiovascular health, and elevated lipoprotein(a)"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3213-0876","authenticated-orcid":false,"given":"Alexander C","family":"Razavi","sequence":"first","affiliation":[{"name":"Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine , Atlanta, GA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikaila P","family":"Reyes","sequence":"additional","affiliation":[{"name":"School of Medicine, University of California San Diego , La Jolla, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John T","family":"Wilkins","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Northwestern Feinberg School of Medicine , Chicago, IL ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moyses S","family":"Szklo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7553-3408","authenticated-orcid":false,"given":"Michael Y","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Minnesota , Minneapolis, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seamus P","family":"Whelton","sequence":"additional","affiliation":[{"name":"Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine , Baltimore, MD ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence S","family":"Sperling","sequence":"additional","affiliation":[{"name":"Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine , Atlanta, GA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sotirios","family":"Tsimikas","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California San Diego , 9500 Gilman Drive, MC 7411, La Jolla, CA 92093 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3964-2989","authenticated-orcid":false,"given":"Harpreet S","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California San Diego , 9500 Gilman Drive, MC 7411, La Jolla, CA 92093 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,11,28]]},"reference":[{"key":"2025071405522416800_zwae382-B1","doi-asserted-by":"crossref","first-page":"e48","DOI":"10.1161\/ATV.0000000000000147","article-title":"Lipoprotein(a): a genetically determined, causal, and prevalent risk factor for atherosclerotic cardiovascular disease: a scientific statement from the American Heart Association","volume":"42","author":"Reyes-Soffer","year":"2022","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"2025071405522416800_zwae382-B2","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.jacc.2017.11.014","article-title":"Unmet needs in understanding lipoprotein(a) pathophysiology: 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