Plasma lipoprotein(a) indicates risk for 4 distinct forms of vascular disease.

Abstract

BACKGROUND:

Increased lipoprotein(a) [Lp(a)] concentrations are predictive for coronary artery disease (CAD). The risk conferred by Lp(a) for other types of vascular disease compared with CAD has not been investigated within a single population. This study aimed to investigate Lp(a) risk association for 4 different types of vascular disease (including CAD) within a predominantly white population.

METHODS:

We used an Lp(a) ELISA that measures Lp(a) independently of apolipoprotein(a) size to measure plasma Lp(a) in patients [384 CAD, 262 peripheral vascular disease, 184 ischemic stroke (stroke), 425 abdominal aortic aneurysm] and 230 disease-free controls. We then conducted association studies with logistic regression, integrating the potential confounding effects of age, sex, diabetes, plasma lipids, and a history of previous hypertension, hypercholesterolemia, and smoking.

RESULTS:

Multivariate analyses with Lp(a) concentrations of >45 nmol/L (the 75th percentile value for controls) as the clinical cutoff showed increased Lp(a) concentrations to be a risk factor for all disease groups, with adjusted odds ratios ranging from 1.96 [95% confidence interval (CI) 1.24-3.08] for CAD to 2.33 (95% CI 1.39-3.89) for PVD. The risk conferred by Lp(a) appeared to be independent of other confounders, including exposure to statin/fibrate therapies. Similar odds ratios and CIs between disease groups indicated that increased Lp(a) conferred a similar risk for all groups studied.

CONCLUSIONS:

Lp(a) constitutes a stable risk factor of similar magnitude for 4 major forms of vascular disease. This association was not altered by exposure to standard lipid-lowering therapy.

• Authors: Gregory T Jones, Andre M van Rij, Jennifer Cole, Michael J A Williams, Emma H Bateman, Santica M Marcovina, Meiying Deng, Sally P A McCormick
• Journal: Clinical chemistry (Clin Chem) Vol. 53 Issue 4 Pg. 679-85 (Apr 2007) ISSN: 0009-9147 [Print] England
• PMID: 17303687 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Lipoprotein(a)

Topics

• Aged
• Aortic Aneurysm, Abdominal (epidemiology, ethnology)
• Coronary Artery Disease (epidemiology, ethnology)
• Female
• Humans
• Lipoprotein(a) (blood)
• Male
• Peripheral Vascular Diseases (epidemiology, ethnology)
• Plasma
• Reference Values
• Risk
• Stroke (epidemiology)
• White People