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Lipoprotein(a) and heart failure: a systematic review

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Abstract

The role of lipoprotein(a) [Lp(a)] as a possible causal risk factor for atherosclerotic artery disease and aortic valve stenosis has been well established. However, the information on the association between Lp(a) levels and heart failure (HF) is limited and controversial. The main objective of the present study was to assess the association between Lp(a) levels and HF. This systematic review was performed according to PRISMA guidelines. A literature search was performed to detect studies that evaluated the association between Lp(a) levels and HF. Eight studies, including 73,410 patients, were eligible for this research. Seven prospective or retrospective cohorts and one cross-sectional study were analyzed. Five studies analyzed populations without HF; another three included patients with HF or left ventricular dysfunction. The endpoints evaluated varied according to the study analyzed, including incident HF, HF hospitalizations, and decreased left ventricular ejection fraction. Lp(a) levels were also analyzed in different ways, including analysis of Lp(a) as a continuous or categorical variable (distinct cut-off points or percentiles). Globally, the studies included in this review found predominantly positive results. Data on some relevant subgroups, such as HF of ischemic or non-ischemic etiology or HF with or without left ventricular dysfunction, was poorly reported. This systematic review suggests that there would be a positive relationship between Lp(a) levels and HF. Given the complexity and heterogeneity of HF, new studies should be developed to clarify this topic.

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Authors and Affiliations

  1. Cardiology Department, Hospital Italiano de Buenos Aires, Perón 4190, Ciudad Autónoma de Buenos Aires, C1199ABB, Buenos Aires, Argentina

    Walter Masson & Leandro Barbagelata

  2. Servicio de Cardiología, Sanatorio Finochietto, Buenos Aires, Argentina

    Augusto Lavalle-Cobo

  3. Facultad de Medicina, Universidad FASTA, Mar del Plata, Argentina

    Pablo Corral

  4. Centro de Investigación en Endocrinología, Nutrición y Metabolismo (CIENM), Facultad de Ciencias de la Salud, Universidad Nacional de Formosa, Formosa, Argentina

    Juan P. Nogueira

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Contributions

WM and LB participated in the conception and design of the research. WM, LB and JPN participated in the data collection. The interpretation of the data was done by WM, ALC and PC. WM, LB and JPN drafted the manuscript. All authors performed a critical review of the final document. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Walter Masson.

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Masson, W., Barbagelata, L., Lavalle-Cobo, A. et al. Lipoprotein(a) and heart failure: a systematic review. Heart Fail Rev 28, 1307–1314 (2023). https://doi.org/10.1007/s10741-023-10333-2

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