Researchers in Malaysia are studying a hidden heart disease risk factor called lipoprotein(a), or Lp(a) for short. While doctors have long focused on regular cholesterol levels, some people with healthy cholesterol still develop heart disease. This new study will examine whether Lp(a) levels—which are largely determined by your genes—can predict who will have severe heart blockages. The researchers will also look at how diet and specific genetic variations affect Lp(a) levels in different ethnic groups. Understanding Lp(a) better could help doctors identify people at higher risk and prevent heart disease more effectively.

The Quick Take

  • What they studied: Whether a blood protein called lipoprotein(a) can predict how severe heart blockages will be, and how genes and diet affect this protein in Malaysian adults
  • Who participated: Adults in Malaysia who have had heart imaging tests (angiography) to check for blockages. The study compares people with and without heart disease
  • Key finding: This is a study plan, not yet completed results. The researchers will measure Lp(a) levels and look for connections between this protein, genetic variations, diet, and the severity of heart blockages
  • What it means for you: If Lp(a) proves to be an important risk factor, doctors may start testing for it and recommending lifestyle changes or treatments for people with high levels, even if their regular cholesterol is normal

The Research Details

This is a case-control observational study, which means researchers will compare two groups: people who have had heart blockages (cases) and people who haven’t (controls). Over three years, they’ll collect blood samples to measure Lp(a) levels and analyze genetic material to identify specific gene variations. They’ll also ask participants about their eating habits using a detailed food questionnaire. The researchers will use statistical tests to find connections between Lp(a) levels, genetic variations, diet patterns, and the severity of heart blockages seen on imaging tests.

The study is happening at multiple hospitals and medical centers across Malaysia, which helps ensure the findings apply to different populations. Researchers will measure Lp(a) using a laboratory method that detects the protein in blood, and they’ll identify genetic variations using advanced DNA analysis techniques.

This approach is valuable because it allows researchers to study real-world patients and their medical records rather than doing an experiment. It’s particularly useful for understanding how genes, diet, and disease severity connect in specific ethnic groups.

Understanding Lp(a) is important because current heart disease prevention focuses mainly on lowering LDL cholesterol (the ‘bad’ cholesterol). However, many people with normal cholesterol levels still have heart attacks and strokes. If Lp(a) is proven to be an independent risk factor, it could change how doctors screen for and prevent heart disease. Additionally, studying ethnic-specific genetic variations is crucial because genetic risk factors can differ between populations, and findings from one group may not apply equally to others.

This is a study protocol (a detailed plan) rather than completed research, so results aren’t available yet. The study has received ethical approval from multiple Malaysian institutions, which is important for protecting participant safety. The researchers are using validated, established methods for measuring Lp(a) and analyzing genes. The multi-center design strengthens the study by including diverse participants. However, as an observational study, it can show associations but cannot prove that Lp(a) directly causes heart disease severity.

What the Results Show

This is a study protocol published before data collection and analysis, so primary findings are not yet available. The researchers plan to determine whether Lp(a) levels are associated with the severity of heart blockages as measured by imaging tests. They will use statistical methods to account for other factors that affect heart disease risk (like age, smoking, and diabetes) to isolate the independent effect of Lp(a).

Once completed, this study will provide evidence about whether Lp(a) should be routinely measured in clinical practice. The findings may show that Lp(a) is a strong predictor of heart disease severity in Malaysian populations, which could lead to new screening recommendations.

The study will also examine how common specific genetic variations (rs10455872 and rs3798220) are in different ethnic groups within Malaysia. This is important because the same genetic variations may have different frequencies and effects in different populations. Additionally, researchers will analyze dietary patterns to see if certain eating habits are associated with higher or lower Lp(a) levels. This could reveal whether diet modifications might help manage Lp(a) levels, though genetics play a major role.

Previous research has shown that Lp(a) is an independent risk factor for heart disease in some populations, but most studies have focused on European ancestry groups. This Malaysian study is valuable because it will provide data on ethnic-specific patterns, which is an important gap in current knowledge. The focus on dietary patterns adds a practical element, as diet is one of the few modifiable factors that might influence Lp(a) levels.

As a study protocol, the actual limitations won’t be fully known until the research is completed. However, potential limitations include: the study is observational, so it can show associations but not prove cause-and-effect; results may only apply to Malaysian populations and may not generalize to other ethnic groups; and the study relies on participants accurately reporting their diet, which can be challenging. Additionally, Lp(a) levels are primarily determined by genetics, so even if diet is associated with Lp(a), the effect may be modest.

The Bottom Line

This study is in the planning stage, so clinical recommendations cannot yet be made. However, if results confirm that Lp(a) is a strong predictor of heart disease severity, future recommendations may include: (1) Routine Lp(a) testing for people with family histories of early heart disease, (2) Genetic counseling for those with high Lp(a) levels, and (3) Evaluation of whether diet modifications can help manage Lp(a). These recommendations would have moderate confidence once the study is complete and results are published.

This research is particularly relevant for: people with family histories of early heart disease, individuals with normal cholesterol but heart disease symptoms, Malaysian adults and other Asian populations, and healthcare providers managing cardiovascular disease. People with already-diagnosed heart disease should continue following their doctor’s current treatment plans while awaiting these findings.

This is a 3-year study, so results won’t be available until approximately 2027-2028. Even after data collection ends, analysis and publication will take additional time. Meaningful changes to clinical practice based on these findings would likely occur 1-2 years after publication.

Want to Apply This Research?

  • Once Lp(a) testing becomes available, users could track their Lp(a) levels annually alongside traditional cholesterol measurements, noting the date and value. This creates a personal health record showing trends over time.
  • Users could log their daily diet using the app’s food tracking feature and correlate dietary patterns with any future Lp(a) test results. This helps identify which foods or eating patterns might influence their personal Lp(a) levels, even though genetics play the primary role.
  • Establish a long-term monitoring approach where users record Lp(a) test results when available, track family history of early heart disease, and maintain detailed dietary logs. The app could send reminders for annual testing and help users identify dietary patterns to discuss with their healthcare provider.

This article describes a research study protocol and does not present completed findings. Lp(a) testing is not yet standard clinical practice in most settings. If you have concerns about heart disease risk, family history of early heart disease, or questions about whether Lp(a) testing is appropriate for you, please consult with your healthcare provider. Do not make changes to your current heart disease treatment or prevention plan based on this article. Always follow your doctor’s recommendations for cholesterol management and cardiovascular health.