Table 2.
Summary risk estimates and stratified analyses for association between circulating Lp(a) and CVD-death in general population, patients with CVD, CRF or DM
| No. of effect sizes | No. of studies | No. of participants | Pooled HR (95%CI) | I2% | p-value (between groups) |
|
|---|---|---|---|---|---|---|
| General population | ||||||
| Overall effect | 8 | 31 | 112,157 | 1.33 (1.11, 1.58) | 82.8 | - |
| Region | ||||||
| Asia | 1 | 1 | 10,413 | 1.45 (0.91, 2.31) | - | 0.93 |
| Europe | 6 | 6 | 29,061 | 1.33 (1.04, 1.69) | 87.4 | |
| Multiple regions combined | 1 | 24 | 72,683 | 1.33 (1.15, 1.54) | - | |
| Follow-up duration | ||||||
| < 10 years | 5 | 28 | 80,285 | 1.21 (1.03, 1.44) | 74 | 0.36 |
| ≥ 10 years | 3 | 3 | 31,872 | 1.45 (1.03, 2.05) | 74.1 | |
| Multiple studies* | ||||||
| Yes | 1 | 24 | 72,683 | 1.33 (1.15, 1.54) | - | 0.96 |
| No | 7 | 7 | 39,474 | 1.34 (1.07, 1.67) | 85 | |
| Adjustment for BMI | ||||||
| Yes | 5 | 28 | 106,328 | 1.30 (1.003, 1.69) | 88.8 | 0.47 |
| No | 3 | 3 | 5,829 | 1.70 (0.86, 3.35) | 55.7 | |
| Adjustment for Lipid-lowering medication | ||||||
| Yes | 2 | 2 | 7,669 | 1.81 (0.56, 5.84) | 79.4 | 0.61 |
| No | 6 | 29 | 104,488 | 1.32 (1.09, 1.60) | 86 | |
| Lp(a) assessment methods | ||||||
| ELISA | 2 | 2 | 10,972 | 1.47 (0.95, 2.28) | 0 | 0.01 |
| ITA | 2 | 2 | 19,060 | 1.48 (1.01, 2.16) | 94.8 | |
| IRMA | 1 | 1 | 1,773 | 0.99 (0.87, 1.13) | - | |
| NM | 2 | 2 | 7,669 | 1.80 (0.56, 5.84) | 79.4 | |
| Multiple methods | 1 | 24 | 72,683 | 1.33 (1.15, 1.54) | - | |
| Patients with CVD | ||||||
| Overall effect | 17 | 17 | 57,019 | 1.25 (1.10, 1.43) | 54.3 | |
| Region | ||||||
| Asia | 3 | 3 | 12,434 | 1.62 (1.33, 2.96) | 0.0 | 0.03 |
| Europe | 12 | 12 | 42,719 | 1.14 (0.99, 1.30) | 47.9 | |
| America | 1 | 1 | 1,383 | 1.33 (0.65, 2.72) | - | |
| Multiple regions combined | 1 | 1 | 483 | 1.39 (0.37, 5.23) | - | |
| Follow-up duration | ||||||
| < 10 years | 16 | 16 | 52,857 | 1.29 (1.12, 1.48) | 55.4 | 0.09 |
| ≥ 10 years | 1 | 1 | 4,162 | 1.02 (0.80, 1.29) | - | |
| Adjustment for BMI | ||||||
| Yes | 9 | 9 | 20,993 | 1.15 (0.97, 1.36) | 53.9 | 0.06 |
| No | 8 | 8 | 36,026 | 1.56 (1.18, 2.06) | 57.9 | |
| Adjustment for Lipid-lowering medication | ||||||
| Yes | 9 | 9 | 50,862 | 1.23 (1.03, 1.47) | 61.5 | 0.52 |
| No | 8 | 8 | 6,157 | 1.38 (1.03, 1.84) | 50.8 | |
| Lp(a) assessment methods | ||||||
| ELISA | 4 | 4 | 3,062 | 1.78 (1.24, 2.57) | 4.8 | 0.04 |
| ITA | 7 | 7 | 44,379 | 1.25 (1.06, 1.47) | 66 | |
| INA | 2 | 2 | 2,956 | 0.89 (0.55, 1.45) | 23.4 | |
| IRMA | 1 | 1 | 966 | 2.59 (1.04, 6.45) | - | |
| Immunoassay method | 1 | 1 | 483 | 1.39 (0.37, 5.23) | - | |
| Photometric assay | 1 | 1 | 3,313 | 0.99 (0.81, 1.20) | - | |
| Latex agglutination assay | 1 | 1 | 1,860 | 1.31 (0.85, 2.02) | - | |
| Patients with CRF | ||||||
| Overall effect | 2 | 2 | 658 | 1.83 (0.19, 17.96) | 89.3 | |
| Patients with DM | ||||||
| Overall effect | 3 | 4 | 4,070 | 2.53 (1.13, 5.64) | 66 |
* Some publications were conducted on more than one cohort study without reporting the separated results. CVD: Cardiovascular disease; CRF: Chronic renal failure; DM: Diabetes mellitus; HR: Hazard ratio; 95%CI: 95% confidence interval; ELISA: Enzyme-linked immunosorbent assay; ITA: Immunoturbidimetric assay; INA: Immunonephelometric assay; IRMA: Immunoradiometric assay; NM: Not mentioned