Received on April 27, 2007
Accepted on November 15, 2007

Lipids, Lipoproteins, and Cardiovascular Risk Factors

Lipoprotein(a) and Cardiovascular Disease in Ethnic Chinese: The Chin-Shan Community Cardiovascular Cohort Study

¹ Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, and Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
² Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
³ Institute of Environmental Health, College of Public Health, China Medical University, Taichung, Taiwan
⁴ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, and Ming-Sheng Healthcare, Taoyuang, Taiwan

^* To whom correspondence should be addressed. E-mail: ytlee{at}ha.mc.ntu.edu.tw.

BACKGROUND: Little is known about lipoprotein(a) [Lp(a)] as a predictor of vascular events among ethnic Chinese. We prospectively investigated the association of Lp(a) with cardiovascular disease and all-cause death in a community-based cohort.

METHODS: We conducted a community-based prospective cohort study of 3484 participants (53% women; age range, 35–97 years) who had complete lipid measurements and were free of a cardiovascular disease history at the time of recruitment. Over a median follow-up of 13.8-years, we documented 210 cases of stroke, 122 cases of coronary heart disease (CHD), and 781 deaths.

RESULTS: The incidences for each event increased appreciably with Lp(a) quartile for stroke and all-cause death, but not for CHD. Baseline Lp(a) concentration by quartile was not significantly associated with stroke, all-cause death, and CHD in multivariate analyses. The multivariate relative risk was significant for stroke at the 90th and 95th percentiles and for total death at the 95th and 99th percentiles.

CONCLUSIONS: Our findings suggest a threshold relationship with little gradient of risk across lower Lp(a) values for stroke and all-cause death in Chinese adults.