The role of lipoprotein(a) in atrial fibrillation: a systematic review.

Introduction: Atrial fibrillation (AF) is the most prevalent form of cardiac arrhythmia worldwide. Early diagnosis and treatment are essential, emphasizing the need to develop novel biomarkers. Lipoprotein(a) [Lp(a)] has recently been widely investigated as a potential risk factor for various cardiovascular conditions, including AF.

Objectives: The study's objective is to systematically review the current knowledge about the role of Lp(a) in AF.

Methods: This systematic review adhered to the PRISMA 2020 guidelines. Full-text original clinical studies in English assessing the role of Lp(a) in AF were included. Systematic reviews, meta-analyses, reviews, case reports, letters to editors, commentaries, conference abstracts, guidelines/statements, expert opinions, and preprints were excluded. A comprehensive search was conducted across five databases on October 22, 2024: Embase, MEDLINE Ultimate, PubMed, Scopus, and Web of Science. The search yielded 26 original, relevant clinical research articles included in this study.

Results: Studies investigating the association between Lp(a) level and the incidence of AF present conflicting findings. However, Mendelian randomization studies advocate a causal association between high Lp(a) and AF. Data suggests that AF patients who experience a stroke or other thromboembolic events tend to have higher Lp(a) concentrations than those without such events.

Conclusions: Existing evidence suggests Lp(a) may play a pathophysiological role in AF patients, especially among patients who experience thromboembolic events. Nevertheless, this field requires further research due to inconsistencies in the existing evidence.