{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:46:38Z","timestamp":1784594798440,"version":"3.55.0"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Korea Health Technology R&D"},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Health & Welfare, the Republic of Korea","award":["HR21C0198"],"award-info":[{"award-number":["HR21C0198"]}]}],"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>Lipoprotein(a) [Lp(a)] is an emerging risk factor for major adverse cardiovascular events (MACE). However, evidence on MACE risk according to Lp(a) level in atherosclerotic patients is insufficient, and more data is needed about whether type 2 diabetes (T2DM) additionally contributes to this risk. We aimed to investigate the association between Lp(a) and MACE in atherosclerotic patients and compare the magnitude of Lp(a)-MACE association in the patients with and without T2DM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Using a retrospective cohort study of atherosclerotic patients with and without T2DM who were screened for Lp(a) between 1 January 2000 to 31 December 2020, we estimated the risk of MACE according to Lp(a) level stratified by quintiles and compared the difference in magnitude of Lp(a)-MACE association according to presence of T2DM with partial likelihood ratio test. The study included 25 826 patients with established atherosclerotic cardiovascular disease, of whom 7535 had T2DM (29.2%) and 18 291 did not (70.8%). During 160 174 person-years (PY) of follow-up, a total of 4836 MACE were observed. Compared to the lowest quintile (Q) of Lp(a) levels, multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for MACEs across Q2 to Q5 were 1.10 (95% CI: 0.94\u20131.30), 0.98 (95% CI: 0.83\u20131.16), and 1.25 (95% CI: 1.06\u20131.46), 1.29 (95% CI: 1.10\u20131.51) in patients with T2DM, and 0.99 (95% CI: 0.88\u20131.12), 1.10 (95% CI: 0.98\u20131.23), 1.01 (95% CI: 0.90\u20131.13), and 1.13 (95% CI: 1.01\u20131.27) for those without T2DM. The strength of Lp(a)-MACE association was stronger among the patients with T2DM (P &amp;lt; 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Among atherosclerotic patients with and without T2DM, elevated Lp(a) level was significantly associated with a higher risk of MACE. Compared to those without T2DM, the patients with T2DM showed an excess MACE risk, suggesting the need for clinical interventions concerning both Lp(a) level and glycemic control.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf036","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T04:37:36Z","timestamp":1741667856000},"page":"733-742","source":"Crossref","is-referenced-by-count":8,"title":["Impact of diabetes on risk of major adverse cardiovascular events associated with lipoprotein(a) levels in patients with established atherosclerotic cardiovascular disease"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2824-8441","authenticated-orcid":false,"given":"Kyuwoong","family":"Kim","sequence":"first","affiliation":[{"name":"National Cancer Control Institute, National Cancer Center , 323 Ilsan-ro, Ilsandong-gu, Goyang 10408 ,","place":["Republic of Korea"]},{"name":"Graduate School of Cancer Science and Policy, National Cancer Center , 323 Ilsan-ro, Ilsandong-gu, Goyang 10408 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minkyoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Information Medicine, Asan Medical Center , 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul 05505 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiye","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Information Medicine, Asan Medical Center , 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul 05505 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeyun","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Computing, Newcastle University , Urban Sciences Building, 1 Science Square, Newcaslte Helix, Newcastle upon Tyne NE4 5TG ,","place":["United Kingdom of Great Britain & Northern Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ah-Ram","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine , 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul 05505 ,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Joon","family":"Jun","sequence":"additional","affiliation":[{"name":"Department of Digital Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43 Gil, Songpa-Gu, Seoul 05505, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Hak","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine , 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul 05505 ,","place":["Republic of 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