Mahmoud Abdelnabi: Evaluating the Evidence on Elevated Lp(a) and VTE Before Clinical Translation
Mahmoud Abdelnabi, FIT programming Committee at American Heart Association, Assistant Professor at Mayo Clinic, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in Atherosclerosis, adding:
“I’m pleased to share our latest publication in Atherosclerosis.
‘Association between elevated lipoprotein(a) and venous thromboembolism: A systematic review and meta-analysis.’
Lipoprotein(a) (Lp(a)) is an established cardiovascular risk factor, but its relationship with venous thromboembolism (VTE) remains uncertain.
In this systematic review and meta-analysis, we examined the available evidence and found several important insights:
- Borderline association: Elevated Lp(a) showed a borderline association with VTE in pooled analyses, with substantial heterogeneity and wide prediction intervals.
- Study design matters: The association was significant in case–control studies but not in prospective cohort studies.
- Causality remains unproven: The findings appear to be driven primarily by lower-quality retrospective evidence, while higher-quality cohort and genetic evidence do not support a clinically meaningful causal relationship.
- Clinical implications: Current evidence does not support routine Lp(a) testing specifically for VTE risk stratification, although a potential effect at extreme Lp(a) levels cannot be excluded.
This work highlights the importance of critically evaluating study design, heterogeneity, and the strength of evidence before translating epidemiologic associations into clinical practice.
Grateful to my co-authors and collaborators for their contributions to this work at Mayo Clinic.”
Title: Association between elevated lipoprotein (a) and venous thromboembolism: A systematic review and meta-analysis
Authors: Mahmoud Abdelnabi, Chanokporn Puchongmart, Ramzi Ibrahim, Sofia Lakhdar, Sammudeen Ibrahim, Hoang Nhat Pham, Luke Dreher, Hussein Abdul Nabi, Juan Farina, Chadi Ayoub, Reza Arsanjani
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