High CAC, Cholesterol Increase Risk of Heart Attacks and Strokes, Study Results Show


Patients with elevated high lipoprotein(a) and coronary artery calcium scores are at risk over the subsequent 10 years, findings from an analysis by cardiologists indicate.

Individuals with a combination of high lipoprotein(a) (Lp(a)) and high coronary artery calcium scores (CAC) face more than a 20% risk of a heart attack or stroke over the subsequent 10 years, according to the results of a study by preventive cardiologists at the University of Texas (UT) Southwestern Medical Center.1

"We are hopeful that by making the connection between Lp(a) and CAC as dual risk drivers, we can raise awareness in the medical community and improve earlier heart attack prevention for these patients," Parag Joshi, MD, associate professor of Internal Medicine at UT Southwestern, said in a statement.1 "Our data may also expedite the development of treatments designed specifically for this high-risk population.”

Investigators, which also included some from Emory University, found that individuals with combined high Lp(a) and high CAC had about a 22% 10-year risk of heart attack or stroke compared with a 10% to 15% 10-year risk in individuals who had just 1 of the risk factors.1

Individuals who had high Lp(a) and no CAC had the lowest 10-year risk of heart attack or stroke, while those who had low Lp(a) and high CAC had a higher-than-average 10-year risk of heart attack or stroke but lower than high Lp(a) CAC combined.1

The findings were published online in the Journal of American College of Cardiology and will appear in the March print edition of the journal.1

"Establishing the connection between Lp(a) and CAC means we can move to the important next phase of research, which will be defining and personalizing early screening protocols to identify patients at high risk of heart attack," Joshi said.1 "With further research, this could mean selectively scanning patients with high Lp(a) for their CAC score and studying therapies specifically designed to reduce Lp(a) among patients with high CAC."

The investigators confirmed the connection between Lp(a) and CAC by comparing data from 2 landmark cardiovascular trials.1

The first trial was the Dallas Heart Study, which is a comprehensive, ongoing study of more than 6000 heart-healthy individuals. UT Southwestern conducted the study starting in 2000.1

The second study was the multi-ethnic study of atherosclerosis, which included 6000 individuals, and investigated early stages of hardening of the arteries.1

Approximately 1 in 6 individuals in the United States have high Lp(a), a type of bad cholesterol whose levels are driven primarily by genes, according to the statement.1

CAC is a marker of plaque deposited around the heart.1

Coronary artery disease (CAD) is the most common type of heart disease, and approximately 18.2 million individuals over aged 20 years have the condition, according to the CDC.2

Approximately 2 in 10 deaths from CAD happen in adults who are younger than aged 65 years, according to the CDC.2


1. High CAC, high cholesterol increase heart attack/stroke risk, cardiologists find. ScienceDaily. News release. February 23, 2022. Accessed March 3, 2022. https://www.sciencedaily.com/releases/2022/02/220223153349.htm

2.Heart disease facts. CDC. Updated February 7, 2022. Accessed March 3, 2022. https://www.cdc.gov/heartdisease/facts.htm

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