Lipoprotein(a) interactions with lipid and non-lipid risk factors in patients with early onset coronary artery disease - Results from the NHLBI Family Heart Study
Pn. Hopkins et al., Lipoprotein(a) interactions with lipid and non-lipid risk factors in patients with early onset coronary artery disease - Results from the NHLBI Family Heart Study, ATHEROSCLER, 141(2), 1998, pp. 333-345
Citations number
100
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Background: A positive interaction between high plasma lipoprotein(a) [Lp(a
)] and unfavorable plasma lipid levels has been reported to result in very
high risk for premature coronary artery disease (CAD). We further examined
this issue for men and women with early onset CAD. We also examined potenti
al interactions between Lp(a) and non-lipid risk factors. Methods and resul
ts: In 338 men and women with early onset CAD (most with a positive family
history of early CAD) and 480 general population controls, we measured Lp(a
), lipids and other risk factors. In univariate analysis, relative odds for
CAD was 1.7 (P = 0.002) for plasma Lp(a) > 50 mg/dl. Elevated Lp(a) level
was found to interact with adjusted plasma total/high density lipoprotein (
HDL) cholesterol such that when Lp(a) was over 50 mg/dl and adjusted plasma
total/HDL cholesterol > 5.8, relative odds for CAD were 8.0-9.6 (P < 0.000
1) in multiple logistic regression. Non-lipid risk factors were generally f
ound to multiply the risk associated with Lp(a) (as predicted by logistic r
egression) without evidence for interaction. Conclusions: We find evidence
that Lp(a) does interact positively with adjusted plasma total/HDL choleste
rol ratio. Aggressive risk factor intervention, especially for lipids, in t
hose with elevated Lp(a) therefore appears indicated. (C) 1998 Elsevier Sci
ence Ireland Ltd. All rights reserved.