Prevalence of high blood lipoprotein(a) levels associated with atherosclerotic cardiovascular disease risk in residents of the Russian Federation: an analysis of 38000 cases

Aim. To study serum lipoprotein(a) (Lp(a)) levels in the general population of the Russian Federation (RF) from various federal districts and to assess the prevalence of elevated Lp(a) levels corresponding to cardiovascular risk (CVR) categories. Material and methods. This retrospective analysis of serum Lp(a) levels was performed in the laboratories of OOO Helix (2021-2024, n=14625) and OOO Invitro (2023-2024, n=23485). A total of 38110 test results in the general population of the Russian Federation were processed. The median age was 49 years (39; 60). The Lp(a) level was determined in two units of measurement: molar — nmol/L (Helix) and mass — g/L (Invitro). Values higher than or equal to 105 nmol/L or 0,5 g/L were considered elevated in serum Lp(a). CVR categories taking into account blood Lp(a) levels were stratified according to the 2023 European Society of Cardiology (ESC) guidelines. Data analysis was conducted across Russian Federation federal districts based on the sex and age of the subjects. Results. A combined analysis of data from two large laboratories representing all Russian showed that, according to the 2023 ESC CVR stratification based on Lp(a) levels, low CVR was detected in 74,9% of subjects, intermediate CVR in 6,7%, moderate CVR in 6,5%, high CVR in 3,9%, very high CVR in 7,5%, and extremely high CVR in 0,5%. Thus, every fifth Russian resident tested had a Lp(a) level ≥0,5 g/L or ≥105 nmol/L, corresponding to moderate or higher CVD. The highest number of individuals with moderate (0,5-0,69 g/L, 105-174 nmol/L), very high (0,9-1,79 g/L, 190-429 nmol/L), and extremely high (≥1,8 g/L, ≥430 nmol/L) CVR was found in the Southern Federal District. The highest proportion of individuals with high CVR (0,7-0,89 g/L, 175-189 nmol/L) were found in the Siberian Federal District. Women had significantly higher Lp(a) levels than men (p=0,001). A moderate increase in blood Lp(a) concentrations with age was observed. Conclusion. The analysis results have important epidemiological significance and demonstrate a high prevalence of increased risk of atherosclerotic cardiovascular disease (ASCVD) associated with elevated blood Lp(a) levels. Variability in Lp(a) levels was identified across different Russian regions, as well as sex and age differences. The results can be used to develop ASCVD screening and prevention strategies.