# Verhoogd lipoproteïne(a) hangt samen met aortaplakruptuur — NOGA-studie

*geplaatst 2026-09-30 · Cholesterol · Atherosclerosis plus · doi 10.1016/j.athplu.2026.100603 · https://hartvaat.nl/2026/12/01/verhoogd-lipoproteine-a-hangt-samen-met-aortaplakruptuur-noga-studie/*

In een cohort van 276 patiënten met coronairlijden bleek een verhoogd lipoproteïne(a)-gehalte (>30 mg/dL) onafhankelijk samen te hangen met aortaplakruptuur, gemeten via non-obstructieve generieke angioscopy (NOGA). Patiënten met een verhoogd lipoproteïne(a) hadden een significant hogere prevalentie van plakruptuur (84% versus 62%; p < 0,001), ongeacht traditionele risicofactoren. Deze bevindingen suggereren dat een verhoogd lipoproteïne(a)-niveau gepaard gaat met aanhoudende vaatwandkwetsbaarheid, ook bij intensieve LDL-C-lowering. Voor de klinische praktijk onderstreept dit het belang van het monitoren van lipoproteïne(a) bij patiënten met een hoge cardiovasculaire risico-inschatting.

## English: Association between serum lipoprotein(a) levels and aortic vulnerable plaques assessed by non-obstructive general angioscopy.

In a cohort of 276 patients with coronary artery disease, elevated lipoprotein(a) levels (>30 mg/dL) were independently associated with aortic plaque rupture, as assessed by non-obstructive general angioscopy (NOGA). Patients with higher lipoprotein(a) had a significantly greater prevalence of plaque rupture (84% vs 62%; p < 0.001) after adjusting for traditional cardiovascular risk factors. These findings suggest that elevated lipoprotein(a) may drive persistent aortic plaque vulnerability despite intensive LDL cholesterol lowering. Routine lipoprotein(a) screening could help identify patients who may benefit from targeted risk-reduction strategies.

## Abstract (original, from the publication)

BACKGROUND AND AIMS: Elevated lipoprotein(a) [Lp(a)] levels are recognized as a genetic risk factor for atherosclerotic cardiovascular disease. Previous coronary imaging studies have linked elevated Lp(a) levels to vulnerable coronary plaque characteristics. However, the relationship between elevated Lp(a) levels and vulnerable aortic plaque characteristics remains unclear. We investigated the association between serum Lp(a) levels and vulnerable aortic plaque characteristics assessed by non-obstructive general angioscopy (NOGA). METHODS: We analyzed 276 consecutive patients with coronary artery disease who underwent NOGA between December 2014 and March 2023. Patients were divided according to serum Lp(a) levels using a 30 mg/dL cutoff. Vulnerable aortic plaque characteristics, including plaque rupture, thrombus, yellow plaque, ulceration, and fissure, were assessed by NOGA. RESULTS: Elevated Lp(a) levels (>30 mg/dL) were observed in 27% of patients, whereas markedly elevated Lp(a) levels (>50 mg/dL) were observed in 14%. Patients with elevated Lp(a) levels showed a significantly higher prevalence of plaque rupture (84% vs. 62%, p < 0.001), thrombus, and fissure than those with lower Lp(a) levels. In contrast, the prevalence of yellow plaque did not differ significantly between groups. The prevalence of plaque rupture progressively increased according to Lp(a) strata. In multivariate logistic regression analysis, elevated Lp(a) levels remained independently associated with plaque rupture after adjustment for traditional cardiovascular risk factors. CONCLUSIONS: Elevated serum Lp(a) levels were independently associated with aortic plaque rupture assessed by NOGA. These findings suggest that elevated Lp(a) levels may be associated with persistent aortic plaque vulnerability despite intensive LDL-C lowering.

Auteurs: Keisuke Kojima, Yudai Tanaka, Katsunori Fukumoto, Yasunari Ebuchi, Tokio Nishiwaki, Naoki Kurito, Satoaki Tomimatsu, Yuta Hotsubo, Tetsuro Nagao, Ran Sumida, Saki Mizobuchi, Shohei Migita, Masatsugu Miyagawa, Koichiro Hori, Yutaka Koyama, Riku Arai, Suguru Migita, Mitsumasa Sudo, Daisuke Fukamachi, Yasuo Okumura

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Bron: Atherosclerosis plus, https://doi.org/10.1016/j.athplu.2026.100603. Bijgewerkt 2026-09-24T00:51:36Z. 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.