Lipoprotein(a) interactions with lipid and nonlipid risk factors in early familial coronary artery disease

Paul N. Hopkins, Lily L. Wu, Steven Hunt, Brent C. James, G. Michael Vincent, Roger R. Williams

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

An interaction between high plasma lipoprotein(a) [Lp(a)], unfavorable plasma lipids, and other risk factors may lead to very high risk for premature CAD. Plasma Lp(a), lipids, and other coronary risk factors were examined in 170 cases with early familial CAD and 165 control subjects to test this hypothesis. In univariate analysis, relative odds for CAD were 2.95 (P<.001) for plasma Lp(a) above 40 mg/dL. Nearly all the risk associated with elevated Lp(a) was found to be restricted to persons with historically elevated plasma total cholesterol (6.72 mmol/L [260 mg/dL] or higher) or with a total/HDL cholesterol ratio >5.8. Nonlipid risk factors were also found to at least multiply the risk associated with Lp(a). When Lp(a) was over 40 mg/dL and plasma total/HDL cholesterol >5.8, relative odds for CAD were 25 (P=.0001) in multiple logistic regression. If two or more nonlipid risk factors were also present (including hypertension, diabetes, cigarette smoking, high total homocysteine, or low serum bilirubin), relative odds were 122 (P<l x 10-12). The ability of nonlipid risk factors to increase risk associated with Lp(a) was dependent on at least a mildly elevated total/HDL cholesterol ratio. In conclusion, high Lp(a) was found to greatly increase risk only if the total/HDL cholesterol ratio was at least mildly elevated, an effect exaggerated by other risk factors. Aggressive lipid lowering in those with elevated Lp(a) therefore appears indicated.

Original languageEnglish
Pages (from-to)2783-2792
Number of pages10
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume17
Issue number11
Publication statusPublished - 1997
Externally publishedYes

Fingerprint

Lipoprotein(a)
Coronary Artery Disease
Lipids
HDL Cholesterol
Odds Ratio
Aptitude
Homocysteine
Bilirubin
Logistic Models
Smoking
Hypertension
Serum

Keywords

  • Case- control studies
  • Coronary heart disease
  • Genetics
  • Lipoprotein(a)
  • Risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hopkins, P. N., Wu, L. L., Hunt, S., James, B. C., Michael Vincent, G., & Williams, R. R. (1997). Lipoprotein(a) interactions with lipid and nonlipid risk factors in early familial coronary artery disease. Arteriosclerosis, Thrombosis, and Vascular Biology, 17(11), 2783-2792.

Lipoprotein(a) interactions with lipid and nonlipid risk factors in early familial coronary artery disease. / Hopkins, Paul N.; Wu, Lily L.; Hunt, Steven; James, Brent C.; Michael Vincent, G.; Williams, Roger R.

In: Arteriosclerosis, Thrombosis, and Vascular Biology, Vol. 17, No. 11, 1997, p. 2783-2792.

Research output: Contribution to journalArticle

Hopkins, Paul N. ; Wu, Lily L. ; Hunt, Steven ; James, Brent C. ; Michael Vincent, G. ; Williams, Roger R. / Lipoprotein(a) interactions with lipid and nonlipid risk factors in early familial coronary artery disease. In: Arteriosclerosis, Thrombosis, and Vascular Biology. 1997 ; Vol. 17, No. 11. pp. 2783-2792.
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