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Relationship between lipoprotein(a) levels, cardiovascular outcomes and death in patients with chronic kidney disease: a systematic review of prospective studies

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Abstract

Introduction and aim

In the general population, high levels of lipoprotein(a) (Lp(a)) are an independent risk factor for atherosclerotic cardiovascular diseases. However, the information available in patients with chronic kidney disease (CKD) is less robust. The main objective of this updated systematic review of prospective studies was to analyze the association between elevated Lp(a) levels and cardiovascular outcomes or death in patients with CKD.

Methods

The PRISMA guidelines were used to carry out this systematic review. Randomized clinical trials or prospective observational studies that evaluated the association between Lp(a) levels and cardiovascular outcomes or death in CKD patients were searched in the current literature.

Results

Fifteen studies including 12,260 individuals were identified and considered eligible for this systematic review. In total, 14 prospective cohorts and one post-hoc analysis of a randomized clinical trial were analyzed. Eight studies evaluated hemodialysis patients, one study analyzed patients on peritoneal dialysis, while six studies evaluated subjects with different stages of CKD. Median follow-up duration ranged from 1 to 8.6 years. Our findings showed that elevated Lp(a) values were associated with a higher risk of cardiovascular events or death in most studies, despite adjusting for traditional risk factors.

Conclusion

The findings of this systematic review show that there is a positive association between Lp(a) levels and fatal and non-fatal cardiovascular events in patients with CKD.

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Data availability

All data generated or analysed during this study are included in this published article.

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

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

    Leandro Barbagelata & Walter Masson

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

    Pablo Corral

  3. Cardiology Department, Sanatorio Finochieto, Buenos Aires, Argentina

    Augusto Lavalle-Cobo

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

    Juan Patricio Nogueira

  5. Nephrology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Guillermo Rosa Diez

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Contributions

W.M and L.B participated in the conception and design of the research. W.M. and L.B participated in the data collection. The interpretation and final selection of the data was done by W.M, L.B and G.RD. W.M, P.C, A.LC and J.P.N. 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 Leandro Barbagelata.

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Barbagelata, L., Masson, W., Corral, P. et al. Relationship between lipoprotein(a) levels, cardiovascular outcomes and death in patients with chronic kidney disease: a systematic review of prospective studies. J Nephrol 36, 1549–1559 (2023). https://doi.org/10.1007/s40620-023-01590-3

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  • DOI: https://doi.org/10.1007/s40620-023-01590-3

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