A real-world study of major adverse cardiovascular events (MACE) among patients with ASCVD and elevated lipoprotein A (Lp[a]) in Ontario

Summary

Client: IQVIA Solutions Canada Inc.

Project ID: P2025-235/2026 0980 011 000

Research Question/Objectives: Atherosclerotic cardiovascular disease (ASCVD) is deposition of apolipoprotein B (apoB)-containing lipoproteins and subsequent immune response in the artery walls.1 A key risk factor for the development of ASCVD is elevated levels of apoB-containing lipoproteins, including low-density lipoprotein (LDL). Lp(a) is another apoB-containing lipoprotein and consists of an LDL particle bound to apolipoprotein(a). Lp(a) is atherogenic, prothrombotic and proinflammatory and as such, elevated Lp(a) levels are an independent causal risk factor for developing ASCVD.2 Lp(a) levels are genetically determined, and are generally stable throughout life.

There are currently no approved pharmacological treatments targeting a reduction in Lp(a). The rate of cardiovascular (CV) events in this population will be investigated to understand the burden of disease and impact of elevated Lp(a) on MACE in patients for whom treatment is currently unavailable.

Objectives:

The primary objectives of the study are to:

1. Describe the baseline characteristics of patients with ASCVD and elevated Lp(a) levels in Ontario, Canada.
2. Describe the frequency of recurrent MACE and mortality among patients with ASCVD and elevated Lp(a) levels in Ontario, Canada.

Additionally, the study the study team will examine the following exploratory objectives:

1. Describe the prevalence of elevated Lp(a) levels among patients with a record of an Lp(a) blood test, and among the general population in Ontario, Canada.
2. Explore treatment patterns in subpopulations of patients with ASCVD and elevated Lp(a) levels in Ontario, Canada.
3. Describe and compare the demographic and clinical characteristics of patients with ASCVD and elevated Lp(a) levels with matched controls in Ontario, Canada.
4. Describe and compare the frequency of recurrent MACE and mortality among patients with ASCVD and elevated Lp(a) levels with matched controls in Ontario, Canada.

Status: In progress