Lipoprotein (a) and development of intermittent claudication and major cardiovascular events in men and women: The Edinburgh Artery Study

Lipoprotein (a) may be an important risk factor for atherosclerosis. It is widely accepted that lipoprotein (a) levels are raised in patients with cor onary heart disease, but there is some doubt about the causality of the rel ationship. In addition, little is known about the relationship between lipo protein (a) and either stroke or peripheral arterial disease, nor about the role of lipoprotein (a) in women. Subjects aged 55-74 years (n = 1592) wer e selected at random from 11 general practices in Edinburgh, Scotland and f ollowed up for 5 years. The incidences of myocardial infarction, intermitte nt claudication and stroke were 13.4, 9.4 and 3.7%, respectively. Raised li poprotein (a) levels at baseline were associated with an increased risk (95 % confidence interval) of myocardial infarction RR 1.15 (1.00, 1.32), inter mittent claudication RR 1.32 (1.10, 1.57) but not significantly for stroke RR 1.24 (0.93, 1.64). This increased risk persisted for intermittent claudi cation after adjustment for baseline cardiovascular disease and other risk factors RR 1.20 (1.00, 1.43), but for myocardial infarction became non-sign ificant RR 1.06 (0.91, 1.23). The risk of disease associated with raised li poprotein (a) was slightly higher in women than in men, especially for inte rmittent claudication (men RR 1.09 (0.87,1.36) compared to women RR 1.37 (1 .01, 1.87)). In conclusion, we found that lipoprotein (a) was an independen t predictor of cardiovascular events in both sexes. The association between lipoprotein (a) and cardiovascular events may have been stronger in women than in men, and for peripheral arterial disease than myocardial infarction and stroke. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.