PREreviews of “The Impact of Lipoprotein(a) Determination in Cardiovascular Risk Stratification Among People Living with HIV”

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The Impact of Lipoprotein(a) Determination in Cardiovascular Risk Stratification Among People Living with HIV

by Carmen Ramos Alejos-Pita, Diego José Rodríguez Torres, Tatiana Mata Forte, Judith del Carmen López Galiendo, Beatriz Tendero de la Asunción, Joaquín Enrique Gómez Sanz, Juan José Reyes Luján, Matteo Romano, Salvador Álvarez Antón, Edurne López Soberón, Francisco Javier Membrillo de Novales, and Miriam Estébanez Muñoz

Posted: November 13, 2025
Server: Preprints.org
DOI: 10.20944/preprints202511.1025.v1

Abstract

Introduction: Human immunodeficiency virus (HIV) infection has become a chronic condition due to antiretroviral therapy (ART), which has increased life expectancy but is also associated with a higher burden of cardiovascular disease (CVD) in people living with HIV (PLHIV). Lipoprotein(a) [Lp(a)] is an independent cardiovascular risk biomarker; however, its role in PLHIV remains unclear. This study evaluated the relationship between Lp(a) and cardiovascular risk and explored its association with subclinical coronary artery disease. Materials and Methods: Cross-sectional study included PLHIV aged ≥40 years on stable ART with sustained viral suppression. Individuals with prior cardiovascular events or type 1/advanced type 2 diabetes were excluded. Lp(a) levels and clinical data were collected. Cardiovascular risk was estimated using validated clinical scores; participants with ≥10% risk underwent coronary computed tomography angiography (CTA) to assess coronary anatomy. Results: A total of 69 patients were included (81% male; mean age 54 years). The mean Lp(a) level was 66.7 nmol/L; 29% had ≥75 nmol/L and 23% ≥125 nmol/L. A non-significant inverse correlation was observed between Lp(a) levels and ART duration (r = –0.209; p = 0.08). Among those with elevated Lp(a), a higher proportion had vulnerable plaques on CTA, although this was not statistically significant. Conclusions: In this cohort of virologically suppressed PLHIV, an inverse trend was observed between ART duration and Lp(a) levels. In the subgroup of moderate-to-high cardiovascular risk, the prevalence of coronary plaque vulnerability features was higher among those with elevated Lp(a), highlighting a possible link between Lp(a) and subclinical atherosclerosis in this population.

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