👤 Mohammad Albaree

Lipoprotein(a) [Lp(a)] is a genetically determined, independent risk factor for atherosclerotic cardiovascular disease (ASCVD), unaffected by conventional lipid-lowering therapy. This study assessed the prevalence of elevated Lp(a) in a large, multiethnic cohort in Dubai, United Arab Emirates (UAE), analyzed its distribution across ethnicities, and evaluated its independence from low-density lipoprotein cholesterol (LDL-C). In a single-center multiethnic cohort study, 746 consecutive patients from Mediclinic Parkview Hospital, Dubai, were included. Serum Lp(a) was measured using a standardized immunoturbidometric assay. Positive Lp(a) was defined as ≥75 nmol/L. Levels were stratified by ethnic subgroups and categorized based on ESC/EAS quartiles and risk thresholds (≥105 nmol/L for high risk; >190 nmol/L for very high risk). The correlation between Lp(a) and directly measured LDL-C was assessed using Spearman's rank correlation in both patients receiving optimal lipid-lowering therapy and in those not receiving therapy. The prevalence of positive Lp(a) levels (≥75 nmol/L) was 30.2 %. At higher thresholds, 13.4 % had high-risk levels (≥105 nmol/L) and 9.9 % had very high-risk levels (>190 nmol/L). Ethnic variations were notable: South Asians (32.4 %) and White/Europeans (32.1 %) had the highest prevalence, while East Asians had the lowest (21.6 %) but the highest median level (200.5 nmol/L). Crucially, there was no correlation between Lp(a) and treated LDL-C in patients on optimal lipid-lowering therapy (Spearman's rho = 0.07, p = 0.38). We identified a high prevalence of elevated Lp(a) in a multiethnic cohort in Dubai, with nearly a quarter at high or severe risk. This risk is entirely independent of LDL-C, revealing a significant hidden burden not captured by standard lipid panels. These findings support integrating Lp(a) screening into regional cardiovascular prevention protocols. Show less