News | Stroke | March 01, 2022

High CAC, High Cholesterol Increase Heart Attack and Stroke Risk, UT Southwestern Cardiologists Find

Parag Joshi, M.D.

March 1, 2022 – Patients with both a high lipoprotein(a) and high coronary artery calcium score (CAC) face a more than 20% risk of heart attack or stroke over the following 10 years, according to findings from a multi-center study led by preventive cardiologists at UT Southwestern Medical Center.

“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,” said cardiologist Parag Joshi, M.D., Associate Professor of Internal Medicine at UT Southwestern.

“Our data may also expedite the development of treatments designed specifically for this high-risk population,” said Dr. Joshi, a member of the Clinical Heart and Vascular Center at UT Southwestern, which is ranked #11 in the nation and #1 in Texas for cardiology and heart surgery, according to U.S. News & World Report.

Approximately one in six people in the U.S. have high Lp(a), a type of bad cholesterol whose levels are driven largely by one’s genes. Coronary artery calcium, known as CAC, is a marker of plaque deposits around the heart.

The team of researchers, which included researchers from Emory University, found that participants with combined high Lp(a) and high CAC had a 22% 10-year risk of heart attack or stroke, compared with a 10-15% 10-year risk in patients who had either risk factor alone.

Investigators identified three distinct risk-related trends:

  • High Lp(a), high CAC: These individuals face the highest 10-year risk of heart attack or stroke.
  • High Lp(a), zero CAC: 10-year heart attack and stroke risk is low when there is no CAC, even if Lp(a) is high.
  • Low Lp(a), high CAC: 10-year heart attack or stroke risk is higher than average but lower than with high LP(a) and high CAC combined. 

The findings are online in the Journal of the American College of Cardiology (JACC) and will appear in the March print edition. Read more at “What Can Lp(a) Add to CAC for ASCVD Risk Prediction? New Insights” at TMTMD.

“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,” said Dr. Joshi, whose research focuses on assessing risk for heart attack and stroke, CAC, cholesterol, and coronary CT angiography. “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.”

Cardiology researchers confirmed the Lp(a) and CAC connection by comparing data from two landmark cardiovascular trials:

  • The Dallas Heart Study, an ongoing comprehensive study of 6,000 diverse and heart-healthy patients conducted by UT Southwestern from 2000 to present
  • Multi-Ethnic Study of Atherosclerosis (MESA): A 6,000-participant study investigating early-stage atherosclerosis (hardening of the arteries).

Authors included researchers from UT Southwestern, Emory Clinical Cardiovascular Research Institute, Virginia Commonwealth University Pauley Heart Center, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Wake Forest Baptist Medical Center, Albert Einstein College of Medicine, University of Minnesota, Baylor College of Medicine, and the Michael E. DeBakey Veterans Affairs Medical Center in Houston. Financial disclosures for the authors are included in the manuscript. The MESA study is supported by the National Heart, Lung, and Blood Institute and the National Center for Advancing Translational Sciences. The DHS study was funded by the Donald W. Reynolds Foundation, and partially supported by the National Center for Advancing Translational Sciences of the National Institutes of Health.

For more information: https://utswmed.org


Related Content

News | Heart Failure

June 27, 2024 — The human body has sophisticated defenses against the deposition of calcium minerals that stiffen heart ...

Home June 27, 2024
Home
News | Heart Failure

June 24, 2024 — Endotronix, Inc., a privately held company dedicated to advancing the treatment of heart failure (HF) at ...

Home June 24, 2024
Home
News | Heart Failure

June 18, 2024 — As we commemorate Juneteenth 2024, JACC, the flagship journal of the American College of Cardiology, has ...

Home June 18, 2024
Home
News | Heart Failure

June 7, 2024 — Calcific aortic valve disease (CAVD) is the major heart valve disease that afflicts nearly 10 million ...

Home June 07, 2024
Home
News | Heart Failure

June 7, 2024 — BioCardia, Inc., a company focused on cellular and cell-derived therapeutics for the treatment of ...

Home June 07, 2024
Home
News | Heart Failure

May 28, 2024 — Yoga focused on breathing, meditation, and relaxation is linked with symptom improvement in patients with ...

Home May 28, 2024
Home
News | Heart Failure

May 22, 2024 — New research from The Cooper Institute and partners at University of Texas (UT) Southwestern Medical ...

Home May 22, 2024
Home
News | Heart Failure

April 30, 2024 — A multicenter study led by Vanderbilt University Medical Center (VUMC) and Lipscomb University College ...

Home April 30, 2024
Home
News | Heart Failure

April 16, 2024 — Each year more than 500,000 Americans undergo percutaneous coronary intervention, or PCI, a minimally ...

Home April 16, 2024
Home
News | Heart Failure

April 12, 2024 — University of Virginia School of Medicine researchers have discovered a gene on the Y chromosome that ...

Home April 12, 2024
Home
Subscribe Now