Association of aortic dissection and lipoprotein (a): a meta-analysis

Background and Aim:Some studies reported a positive relation between aortic dissection (AD) and increased lipoprotein (a) (LP(a)), while other studies reported no association, so the authors aimed to do a meta-analysis to establish the relation between AD and high levels of LP(a). Methods:PubMed, Scopus, Web of Science, SAGE, EMBASE, Science Direct, and Cochrane Library were searched. The inclusion criteria were any randomized control trials or observational studies that measured the levels of LP(a) in AD patients and healthy controls. The authors excluded case reports, case series, noncontrolled studies, reviews, editorials, and animal studies. Results:After a search of the literature, four studies were included in the meta-analysis with 678 patients included in the analysis. The pooled analysis showed a statistically significant association between the AD group and increased levels of LP(a), decreased levels of TG, low-density lipoprotein cholesterol, and TC compared with the control group (MD=11.71, 95% CI=4.11-19.32, P-value=0.003), (MD=-0,32, 95% CI=-0.48 to -0.16, P-value<0.0001 ), (MD=-0,21, 95% CI=-0.42 to -0.1, P-value=0.04), (MD=-0,58, 95% CI=-0.62 to -0.54, P-value<0.00001), respectively. Conclusion:Our study showed that AD is significantly associated with increased levels of LP(a). The significant increase in LP(a) in AD was associated with decreased levels of TG, low-density lipoprotein cholesterol, and TC. Future clinical trials testing Lp (a) targeting medications could be useful in the primary, or secondary prevention of AD in high risk patients.