Lipoprotein(a) Levels and Risk of Future Coronary Heart Disease<subtitle>Large-Scale Prospective Data</subtitle>
Abstract
BACKGROUND: Large-scale prospective data are needed to determine whether associations between lipoprotein(a) (Lp[a]) and coronary heart disease (CHD) risk are independent of established risk factors, to characterize the shape of this relationship, and to quantify associations in relevant subgroups. METHODS: Levels of Lp(a) were measured in samples obtained at baseline from 2047 patients who had first-ever nonfatal myocardial infarction or who died of CHD during the study and from 3921 control participants in the Reykjavik Study (n=18 569), as well as in paired samples obtained 12 years apart from 372 participants to quantify within-person fluctuations. RESULTS: Baseline Lp(a) levels had little or no correlation with known cardiovascular risk factors, such as age, sex, total cholesterol level, and blood pressure. The Lp(a) values were highly consistent from decade to decade, with a regression dilution ratio (calculated on the log scale) of 0.92 (95% confidence interval, 0.85-0.99). The odds ratio for CHD, unaltered after adjustment for several established risk factors (age, sex, smoking status, blood pressure, total cholesterol, triglycerides level, diabetes mellitus, and body mass index), was 1.60 (95% confidence interval, 1.38-1.85) in a comparison of extreme thirds of baseline Lp(a) levels. Odds ratios were progressively higher with increasing Lp(a) levels and did not vary materially by several individual- or study-level characteristics. CONCLUSIONS: There are independent, continuous associations between Lp(a) levels and risk of future CHD in a broad range of individuals. Levels of Lp(a) are highly stable within individuals across many years and are only weakly correlated with known risk factors. Further assessment of their possible role in CHD prevention is warranted.
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Studies over the past decade have confirmed and more robustly demonstrated a risk factor role of Lp(a) for cardiovascular disease.
“Recently, interest in Lp(a) has increased because studies over the past decade have confirmed and more robustly demonstrated a risk factor role of Lp(a) for cardiovascular disease (43-46).”
From Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline (2012) · cites this paper as [43]
Hyper-Lp(a)-lipoproteinemia is a risk factor for ASCVD.
“[Statement]Hyper-Lp(a)-lipoproteinemia is a risk factor for ASCVD. (Evidence level: E-1a)”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [224]
Lp(a) is an independent risk factor for CAD and stroke.
“Lp(a) is an independent risk factor for CAD and stroke.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [224]
When the size of apolipoprotein (a) [apo(a)] is small, the concentration of Lp(a) is high, and there is a high risk of CVD.
“When the size of apolipoprotein (a) [apo(a)] is small, the concentration of Lp(a) is high, and there is a high risk of CVD.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [224]
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- Authors
- Bennet, A.
- Affiliations
- University of Cambridge (GB)
- Corresponding author
- Bennet, Anna
- ORCID
- Bennet, Anna
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2008-03-24
- Volume
- 168
- Issue
- 6
- Pages
- 598
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2064043401
- Cited by
- 281
- References
- 84
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 12 · 2023: 13 · 2022: 11 · 2021: 9 · 2020: 15 · 2019: 13 · 2018: 15 · 2017: 13 · 2016: 15 · 2015: 16 · 2014: 16 · 2013: 25 · 2012: 17
- FWCI
- 25.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- JAMA Internal Medicine
- Funders
- British Heart Foundation
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Keywords
- lipoprotein(a), coronary artery disease, cardiovascular risk factors, myocardial infarction, Reykjavik Study, regression dilution, within-person variability
- MeSH terms
- Aged, Coronary Disease, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Time Factors, Lipoprotein(a)
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