{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:19:32Z","timestamp":1787008772573,"version":"build-2736575974"},"reference-count":44,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"University Hospital RWTH Aachen"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study assessed the risk associated with moderately elevated lipoprotein(a) (Lp(a)) levels below current thresholds in a statin-treated population and explored possible differences in the effect of Lp(a) between individuals with and without established atherosclerotic cardiovascular disease (ASCVD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The analysis included 17 376 patients aged \u226545 years with established ASCVD or type 2 diabetes from the UK Biobank. The primary endpoint was major adverse cardiovascular events (MACE), defined as non-fatal myocardial infarction (MI), non-fatal stroke, or cardiovascular (CV) mortality. Cardiovascular outcomes were compared between lower and upper Lp(a) tertiles (&amp;lt;12.5 vs. &amp;gt;46.8\u2005nmol\/L) using adjusted Poisson regression models. Generalized additive Cox models were used to examine the continuous dose\u2013response relationship between Lp(a) and MACE risk, stratified by baseline ASCVD status. Compared with the lower Lp(a) tertile, the upper Lp(a) tertile was associated with a 20% higher risk of MACE (P &amp;lt; 0.01), 27% higher risk of hospitalization for MI (P &amp;lt; 0.05), 34% higher rate of coronary revascularization (P &amp;lt; 0.001), and a 30% increased CV mortality (P &amp;lt; 0.05). Stratified dose\u2013response models showed a more pronounced effect of Lp(a) on MACE risk in individuals without established ASCVD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a statin-treated population at high CV risk, moderately elevated Lp(a) levels (&amp;gt;46.8\u2005nmol\/L) below current guideline thresholds are associated with significantly increased risk of CV events, with a substantially stronger effect observed in those without established ASCVD. These findings suggest that current Lp(a) thresholds may underestimate residual CV risk in statin-treated individuals, particularly those without established ASCVD with high CV risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag296","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T11:45:29Z","timestamp":1780055129000},"source":"Crossref","is-referenced-by-count":2,"title":["Lipoprotein(a) and residual cardiovascular risk in statin-treated patients"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5895-486X","authenticated-orcid":false,"given":"Sam-Lennart","family":"Oftadeh","sequence":"first","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care Medicine (Med. Clinic I), University Hospital RWTH Aachen, RWTH Aachen University , Pauwelsstra\u00dfe 30, Aachen 52074 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8559-2564","authenticated-orcid":false,"given":"Andreas","family":"P\u00fctz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care Medicine (Med. Clinic I), University Hospital RWTH Aachen, RWTH Aachen University , Pauwelsstra\u00dfe 30, Aachen 52074 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0780-0003","authenticated-orcid":false,"given":"Malte","family":"Jacobsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care Medicine (Med. Clinic I), University Hospital RWTH Aachen, RWTH Aachen University , Pauwelsstra\u00dfe 30, Aachen 52074 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9539-4804","authenticated-orcid":false,"given":"Paul","family":"Balfanz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care Medicine (Med. Clinic I), University Hospital RWTH Aachen, RWTH Aachen University , Pauwelsstra\u00dfe 30, Aachen 52074 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6141-634X","authenticated-orcid":false,"given":"Nikolaus","family":"Marx","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care Medicine (Med. Clinic I), University Hospital RWTH Aachen, RWTH Aachen University , Pauwelsstra\u00dfe 30, Aachen 52074 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1141-1126","authenticated-orcid":false,"given":"Julia","family":"Brandts","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care Medicine (Med. Clinic I), University Hospital RWTH Aachen, RWTH Aachen University , Pauwelsstra\u00dfe 30, Aachen 52074 ,","place":["Germany"]},{"name":"Department of Primary Care and Public Health, Imperial Centre for Cardiovascular Disease Prevention, School of Public Health, Imperial College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8807-6442","authenticated-orcid":false,"given":"Dirk","family":"M\u00fcller-Wieland","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care Medicine (Med. 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