{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:50Z","timestamp":1792785890685,"version":"4.5.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Region Stockholm","award":["FoUI-1021801"],"award-info":[{"award-number":["FoUI-1021801"]}],"id":[{"id":"https:\/\/ror.org\/02zrae794","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Swedish Cancerfonden","award":["22 2270 Pj"],"award-info":[{"award-number":["22 2270 Pj"]}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2023-02079"],"award-info":[{"award-number":["2023-02079"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swedish Heart Lung Foundation","award":["20220334"],"award-info":[{"award-number":["20220334"]}],"id":[{"id":"https:\/\/ror.org\/052261q33","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Novo Nordisk Distinguished Investigator","award":["NNF24OC0091535"],"award-info":[{"award-number":["NNF24OC0091535"]}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]}],"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>To investigate whether elevated Lp(a) is independently associated with cumulative coronary, peripheral, and carotid revascularization burden in a primary prevention cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We analysed 237 729 UK Biobank participants of European ancestry free of ASCVD at baseline, followed for a median of 14.1 years. Lp(a) was analysed using the ESC\/EAS 2025 threshold of 105\u2005nmol\/L and continuously (per 50\u2005nmol\/L increment). The primary outcome was the total number of coronary, peripheral, and carotid revascularization procedures per person. Given the genetically determined, lifelong nature of Lp(a) exposure, to capture the full sequence of procedures over time, rather than time-to-first-event alone, we applied recurrent-event statistical models, including the Andersen\u2013Gill model, negative binomial regression, and the Prentice\u2013Williams\u2013Peterson gap\u2013time model. Overall, 10 731 revascularization procedures occurred in 237 729 participants. The proportion undergoing \u22651 procedure was higher with Lp(a) \u2265 105 vs. &amp;lt;105\u2005nmol\/L (4.36% vs. 2.96%), with larger differences for \u22652 (1.53% vs. 0.95%) and \u22653 procedures (0.36% vs. 0.18%). In Andersen\u2013Gill analysis, Lp(a) \u2265 105\u2005nmol\/L was associated with a higher revascularization rate (HR 1.50, 1.42\u20131.60), with a 55% higher rate of revascularization procedures during follow-up by negative binomial regression (IRR 1.55, 1.45\u20131.65). The association was strongest for the first procedure (HR 1.48, 1.40\u20131.56), attenuated for the second (HR 1.28, 1.09\u20131.50), and non-significant for the third (HR 1.23, 0.94\u20131.62). Findings were consistent across coronary and peripheral territories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large primary prevention cohort, elevated Lp(a) was independently associated with a higher long-term revascularization burden across multiple vascular territories. The association was robust for coronary, supportive for peripheral, and inconclusive for carotid revascularization owing to limited statistical power. These findings, derived from recurrent-event methodology, provide a more complete quantification of Lp(a)-associated cardiovascular procedural risk than time-to-first-event analyses alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag499","type":"journal-article","created":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T11:36:00Z","timestamp":1791718560000},"source":"Crossref","is-referenced-by-count":0,"title":["Lipoprotein(a) and long-term revascularization burden: a recurrent-event analysis of the UK Biobank"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4435-1235","authenticated-orcid":false,"given":"Arturo","family":"Cesaro","sequence":"first","affiliation":[{"name":"Department of Translational Medical Sciences, University of Campania \u2018Luigi Vanvitelli\u2019 , Naples ,","place":["Italy"]},{"name":"Division of Cardiology, A.O.R.N. \u2018Sant'Anna e San Sebastiano\u2019 , Caserta ,","place":["Italy"]},{"name":"Centre for Reproduction, Metabolism and Molecular Medicine (CeRM), Department of Medicine (H7), Karolinska Institute, Huddinge , Stockholm 17177 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5018-830X","authenticated-orcid":false,"given":"Paolo","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Campania \u2018Luigi Vanvitelli\u2019 , Naples ,","place":["Italy"]},{"name":"Division of Cardiology, A.O.R.N. \u2018Sant'Anna e San Sebastiano\u2019 , Caserta ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7139-4738","authenticated-orcid":false,"given":"Oveis","family":"Jamialahmadi","sequence":"additional","affiliation":[{"name":"Centre for Reproduction, Metabolism and Molecular Medicine (CeRM), Department of Medicine (H7), Karolinska Institute, Huddinge , Stockholm 17177 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6466-1412","authenticated-orcid":false,"given":"Nicola","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Centre for Reproduction, Metabolism and Molecular Medicine (CeRM), Department of Medicine (H7), Karolinska Institute, Huddinge , Stockholm 17177 ,","place":["Sweden"]},{"name":"Department of Biomedical Sciences, Humanitas University , Pieve Emanuele, MI ,","place":["Italy"]},{"name":"Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Research Hospital , Rozzano, MI ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0887-2265","authenticated-orcid":false,"given":"Valentina","family":"Flagiello","sequence":"additional","affiliation":[{"name":"Centre for Reproduction, Metabolism and Molecular Medicine (CeRM), Department of Medicine (H7), Karolinska Institute, Huddinge , Stockholm 17177 ,","place":["Sweden"]},{"name":"Operative Research Unit of Clinical Medicine and Hepatology, Fondazione Policlinico Universitario Campus Bio-Medico , Via Alvaro del Portillo, Rome 200\u201300128 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6467-5280","authenticated-orcid":false,"given":"Emelie","family":"Barreby","sequence":"additional","affiliation":[{"name":"Centre for Reproduction, Metabolism and Molecular Medicine (CeRM), Department of Medicine (H7), Karolinska Institute, Huddinge , Stockholm 17177 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1126-3071","authenticated-orcid":false,"given":"Rosellina M","family":"Mancina","sequence":"additional","affiliation":[{"name":"Centre for Reproduction, Metabolism and Molecular Medicine (CeRM), Department of Medicine (H7), Karolinska Institute, Huddinge , Stockholm 17177 ,","place":["Sweden"]},{"name":"Department of Life Science, Health, and Health Professions, Link Campus University , Via del Casale di S. Pio V, 44, Rome 00165 ,","place":["Italy"]},{"name":"Research Unit of Clinical Medicine and Hepatology, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma , Via Alvaro del Portillo 21, Rome ,","place":["Italy"]},{"name":"Department of Molecular and Clinical Medicine, University of Gothenburg , Medicinaregatan 3, v\u00e5ning 5, Gothenburg 405 30 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9168-4898","authenticated-orcid":false,"given":"Stefano","family":"Romeo","sequence":"additional","affiliation":[{"name":"Centre for Reproduction, Metabolism and Molecular Medicine (CeRM), Department of Medicine (H7), Karolinska Institute, Huddinge , Stockholm 17177 ,","place":["Sweden"]},{"name":"Department of Molecular and Clinical Medicine, University of Gothenburg , Medicinaregatan 3, v\u00e5ning 5, Gothenburg 405 30 ,","place":["Sweden"]},{"name":"Department of Endocrinology, Karolinska University Hospital , C2:94, H7 Medicine, H7 CeRM Romeo, 14186 Huddinge, Stockholm 171 77 ,","place":["Sweden"]},{"name":"Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Graecia , Campus Universitario \"Salvatore Venuta\"Viale Europa, Localit\u00e0 Germaneto 88100, Catanzaro ,","place":["Italy"]},{"name":"Department of Cardiology, Sahlgrenska University Hospital , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"2026101409130494800_zwag499-B1","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1194\/jlr.R067314","article-title":"Structure, function, and genetics of lipoprotein (a)","volume":"57","author":"Schmidt","year":"2016","journal-title":"J Lipid Res"},{"key":"2026101409130494800_zwag499-B2","doi-asserted-by":"crossref","first-page":"3925","DOI":"10.1093\/eurheartj\/ehac361","article-title":"Lipoprotein(a) in 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