{"id":"bba86257ec6c","type":"article","url":"https://hartvaat.nl/2026/10/07/lp-a-50-mg-dl-versnelt-carotide-atherosclerose-van-plaque-initiatie-tot-stenose-/","title":"Lp(a) ≥ 50 mg/dL versnelt carotide-atherosclerose van plaque-initiatie tot stenose — Suita Study","title_en":"Lipoprotein(a) and the continuum of carotid atherosclerosis from plaque initiation to luminal stenosis: the Suita Study.","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"European journal of preventive cardiology","doi":"10.1093/eurjpc/zwag443","source_url":"https://doi.org/10.1093/eurjpc/zwag443","authors":["Masayuki Teramoto","Yoshihiro Kokubo","Yuka Kato","Sakura Shinohara","Paramita Khairan","Yoko M Nakao","Jun Masui","Kanako Teramoto","Masatoshi Koga","Hiroharu Kataoka"],"significance":6,"published":"2026-10-15","source_date":"2026-10-07","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/lipiden/lp-a-verhoogd/"],"congress":"","summary_en":"In the prospective Suita cohort study (n = 3,272 cardiovascularly healthy adults), researchers examined the long-term association between lipoprotein(a) [Lp(a)] and the progression of carotid atherosclerosis. Over a median follow-up of 11.5 years, Lp(a) levels ≥ 50 mg/dL were associated with a higher risk of incident plaque (HR 1.27; 95% CI 1.01–1.61), accelerated annual intima-media thickness progression, and more than double the odds of progressing to severe stenosis (≥ 50%; OR 2.29; 95% CI 1.15–4.57) compared with levels < 15 mg/dL. These findings reinforce Lp(a) as a robust marker of long-term cardiovascular risk accumulation, supporting routine screening and tailored risk management for individuals with elevated values.","created":"2026-10-08T01:11:22Z","updated":"2026-10-08T01:11:22Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In de prospectieve Suita-cohortstudie (n = 3272 cardiovasculair gezonde volwassenen) werd de langetermijnassociatie tussen lipoproteïne(a) [Lp(a)] en carotide-atherosclerose onderzocht. Na een mediane follow-up van 11,5 jaar bleek een Lp(a)-spiegel ≥ 50 mg/dL geassocieerd met een hoger risico op incidentele plaque (HR 1,27; 95%-BI 1,01-1,61), versnelde jaarlijkse toename van de intima-media-dikte en een tweemaal hoger risico op progressie naar ernstige stenose (≥ 50%; OR 2,29; 95%-BI 1,15-4,57) vergeleken met < 15 mg/dL. Deze bevindingen onderstrepen de rol van Lp(a) als robuuste risicomarker en pleiten voor screening en intensieve risicomanagement bij patiënten met verhoogde Lp(a)-waarden.","abstract_original":"AIMS: The aim of this study was to investigate the long-term association between lipoprotein(a) [Lp(a)] and the longitudinal continuum of carotid atherosclerosis, from initial plaque formation to progression to carotid stenosis, in a prospective study of a general Japanese population. METHODS AND RESULTS: We studied 3272 participants in the Suita Study (mean age: 58.0 ± 11.5 years; 57.9% women) who were free of cardiovascular disease and carotid plaque at baseline (1995-2004). Follow-up carotid ultrasonography was performed biennially until June 2016. Incident carotid plaque was defined as a maximal intima-media thickness (IMT) ≥ 1.7 mm in the entire carotid artery. Progression from plaque to stenosis was defined as ≥50% stenosis in participants who developed plaques. We employed Cox proportional hazards models for incident plaques, linear mixed-effects models for annual IMT changes, and logistic regression for progression to stenosis. During a median follow-up of 11.5 years, 1432 participants developed carotid plaques. Compared with Lp(a) < 15 mg/dL, the multivariable-adjusted hazard ratio for incident plaque was 1.27 [95% confidence interval (CI), 1.01-1.61] for Lp(a) ≥ 50 mg/dL. Participants with Lp(a) ≥ 50 mg/dL had significantly accelerated annual progression of maximal IMT (β = 0.014 mm/year; 95% CI, 0.003-0.025) compared with those with Lp(a) < 15 mg/dL. Furthermore, high Lp(a) levels were associated with progression to ≥50% carotid stenosis (multivariable-adjusted odds ratio, 2.29; 95% CI, 1.15-4.57). CONCLUSION: Elevated Lp(a) levels (≥ 50 mg/dL) were associated with the longitudinal continuum of carotid atherosclerosis, from plaque initiation to advanced stenosis. These findings suggest that high Lp(a) levels serve as a robust marker for long-term cardiovascular risk accumulation, highlighting the importance of screening and potential targeted interventions in individuals with Lp(a) ≥ 50 mg/dL."}