Elevated lipoprotein(a)levels predict all-cause mortality and cardiovascular events in maintenance hemodialysis patients
FU Xin-yi
BAI Ma-qiao
LEI Chen-yu
XU An-ning
YUAN Lin-lin
CAI Wen-jing
ZHANG Li
YE Zhi-ming
LI Zhi-lian
Abstract：Background Lipoprotein(a) [Lp(a)] has been demonstrated to be closely associated with the development of cardiovascular disease (CVD), but its prognostic value in maintenance hemodialysis (MHD) patients remains controversial. This study aimed to evaluate the association between Lp(a) levels and adverse outcomes in this high-risk population, with a focus on both mortality and new-onset cardiovascular events (CV events). Methods In this retrospective observational study, we enrolled 181 MHD patients who were stratified into normal Lp(a) level group [Lp(a) ≤ 300 mg/L, n=112] and elevated Lp(a) level group [Lp(a) > 300 mg/L, n=69]. Survival analysis was performed using Kaplan-Meier curves, and Cox regression models were employed to evaluate the impact on all-cause mortality and new-onset CV events. Results Over a median follow-up of 79.0 months (IQR: 45.0-109.0), the elevated Lp(a) group exhibited significantly increased CV events incidence (79.7% vs. 29.5%, P < 0.001). Elevated Lp(a) was independently associated with higher risks of all-cause mortality (multivariable-adjusted HR: 2.220, 95% CI: 1.039-4.740) and new-onset CV events (HR: 3.614, 95% CI: 2.164-6.035). Each 10 mg/L Lp(a) increment conferred a 1.1% increased cardiovascular risk (P < 0.001). Conclusions Elevated Lp(a) is a strong, independent predictor of all-cause mortality and new-onset CV events in MHD patients. These findings highlighted the potential utility of Lp(a) in routine CVD risk assessment and underscored the need for targeted therapies to mitigate residual risk in this population. [S Chin J Cardiol 2025;26(2):59-68]
Keywords：Lipoprotein(a)DialysisCardiovascular disease riskAll-cause mortalityPrognostic value
Publication Date：2025-06-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：10( 59-68 )