ASSOCIATION BETWEEN LIPOPROTEIN(A), DIETARY FATS, AND CARDIAC MORTALITY

Abstract

Therapeutic Area: ASCVD/CVD Risk Factors Background: Lipoprotein(a) (Lp(a)) and diet are established risk factors for atherosclerotic cardiovascular disease. Although diet has little direct impact on Lp(a) levels, it is unknown whether dietary fat intake modifies the relationship between Lp(a), and cardiac death (CD). Methods: We used the Atherosclerotic Risk in Communities (ARIC) 30-day dietary recall, laboratory and community surveillance data. We used multivariate cox proportional hazard modeling with interaction terms and marginal outputs to determine if the association between Lp(a) and atherosclerotic CD is mediated by baseline dietary fat intake. Covariates were age, sex, race, HDL, nonHDL (Lp(a)-corrected), smoking status, prior MI, prior stroke, hypertension, diabetes, and obesity. Results: The sample (n=15,027) averaged 54.2 years-old and was mostly female (54.5%) and Caucasian (73.9%). In univariate analysis (HR, p-value) CD was associated with Lp(a) (1.14 per ln increase, <0.001; 1.38 for ≥30mg/dL, <0.001) and highest versus lowest tertile of animal (1.36, <0.001), saturated (1.21, 0.005), and monounsaturated fat intake (1.18, 1.03-1.35, 0.014), but not vegetable, polyunsaturated, or omega-3 fats . In multivariate analysis, baseline fat intake did not mediate the association between Lp(a) and CD (Table). Conclusion: The relationship between Lp(a), CD, and dietary intake is complex. Longer term dietary recall and additional studies are needed to completely understand if lifestyle mediates Lp(a)-associated risks.