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Received on September 11, 2007
Accepted on January 15, 2007
Lipids, Lipoproteins, and Cardiovascular Risk Factors |
1 Department of Medical and Surgical Sciences, University of Otago, Dunedin, New Zealand
2 Department of Biochemistry, University of Otago, Dunedin, New Zealand
3 New Zealand and the Department of Medicine (SMM), Northwest Lipid Research Laboratories, University of Washington, Seattle, WA
* To whom correspondence should be addressed. E-mail: greg.jones{at}otago.ac.nz.
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 apo(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 confidence intervals 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.
The following articles in journals at HighWire Press have cited this article:
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  J.-a. Wang, X.-f. Chen, W.-f. Yu, H. Chen, X.-f. Lin, M.-j. Xiang, C.-f. Fang, Y.-x. Du, and B. Wang Relationship of heavy drinking, lipoprotein (a) and lipid profile to infrarenal aortic diameter Vascular Medicine, November 1, 2009; 14(4): 323 - 329. [Abstract] [PDF]
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 G. T. Jones, M. Deng, G. D. Hammond-Tooke, S. P. A. McCormick, and A. M. van Rij Increased Plasma Lipoprotein(a) Found in Large-Artery Atherosclerotic, but Not Small-Artery Occlusive, Stroke Clin. Chem., October 1, 2009; 55(10): 1888 - 1890. [Full Text] [PDF]
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 H. Takagi, H. Manabe, N. Kawai, S.-n. Goto, and T. Umemoto Circulating lipoprotein(a) concentrations and abdominal aortic aneurysm presence Interactive CardioVascular and Thoracic Surgery, September 1, 2009; 9(3): 467 - 470. [Abstract] [Full Text] [PDF]
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 J. Golledge, P. S. Tsao, R. L. Dalman, and P. E. Norman Circulating Markers of Abdominal Aortic Aneurysm Presence and Progression Circulation, December 2, 2008; 118(23): 2382 - 2392. [Full Text] [PDF]
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 G. T. Jones, A. R. Thompson, F. M. van Bockxmeer, H. Hafez, J. A. Cooper, J. Golledge, S. E. Humphries, P. E. Norman, and A. M. van Rij Angiotensin II Type 1 Receptor 1166C Polymorphism Is Associated With Abdominal Aortic Aneurysm in Three Independent Cohorts Arterioscler Thromb Vasc Biol, April 1, 2008; 28(4): 764 - 770. [Abstract] [Full Text] [PDF]
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K.-L. Chien, H.-C. Hsu, T.-C. Su, F.-C. Sung, M.-F. Chen, and Y.-T. Lee Lipoprotein(a) and Cardiovascular Disease in Ethnic Chinese: The Chin-Shan Community Cardiovascular Cohort Study Clin. Chem., February 1, 2008; 54(2): 285 - 291. [Abstract] [Full Text] [PDF]
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B. Dieplinger, A. Lingenhel, N. Baumgartner, W. Poelz, H. Dieplinger, M. Haltmayer, F. Kronenberg, and T. Mueller Increased Serum Lipoprotein(a) Concentrations and Low Molecular Weight Phenotypes of Apolipoprotein(a) Are Associated with Symptomatic Peripheral Arterial Disease Clin. Chem., July 1, 2007; 53(7): 1298 - 1305. [Abstract] [Full Text] [PDF]
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