Aspirin provides cardiovascular protection benefits in people with high lipoprotein (Lp(a)) levels, a new study finds.
The results of a study on the cardiovascular protective effect of aspirin administration in people with high Lp(a) levels conducted by Paul LaCaze and others from the Department of Public Health and Preventive Medicine at Monash University, Australia, were published on the 26th in JACC, the Journal of the American Heart Association (doi/full). /10.1016/j.jacc.2022.07.027).
Lp(a) is a protein responsible for transporting cholesterol and other lipids. Recent studies have shown that high levels of Lp(a) are recognized as an independent risk factor for cardiovascular disease.
Currently, only PCSK9 inhibitors reduce Lp(a) levels, but statins used to treat dyslipidemia are controversial because they increase Lp(a) levels.
Given the unclear role of aspirin in lipoprotein-mediated atherosclerotic events, the researchers sought to evaluate whether low-dose aspirin may help prevent cardiovascular events in individuals with high plasma Lp(a)-associated genotypes.
The study was followed up for an average of 4.7 years in 12,815 people aged 70 years or older who were enrolled in the ASPREE randomized controlled trial of aspirin.
The analysis showed an interaction between aspirin administration and cardiovascular events in individuals with high plasma Lp(a) genotypes.
The hazard ratio (HR) of major cardiovascular events (MACE) in the high-risk group treated with placebo was 1.9, and a relative risk reduction was observed in the aspirin group, 1.41.
In all participants, aspirin decreased MACE by 1.7 per 1000 subjects and increased clinically significant bleeding by 1.7 per 1000 subjects.
However, in people with the genotype, aspirin did not increase the risk of bleeding significantly and reduced it by 11.4 cases per 1000 person-years.
The researchers concluded that “aspirin may be helpful as a first-line anti-cardiovascular agent in the elderly with a high Lp(a) genotype.”
