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Lipoprotein (a) and coronary heart disease among women: beyond a cholesterol carrier?

Iris Shai1, Eric B Rimm, Susan E Hankinson

  • 1Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. ishai@hsph.harvard.edu

European Heart Journal
|April 13, 2005
PubMed

Insights

High lipoprotein(a) [Lp(a)] levels significantly increase the risk of coronary heart disease (CHD) events in women. This finding suggests Lp(a) may play a role in thrombosis and inflammation, impacting cardiovascular health.

Area of Science:

  • Cardiovascular Science
  • Biochemistry
  • Epidemiology

Background:

  • Lipoprotein(a) [Lp(a)], due to its structural similarity to plasminogen, is implicated in thrombosis and inflammation.
  • Assessing Lp(a)'s role in coronary heart disease (CHD) requires assays unaffected by plasminogen-like repeats.

Purpose of the Study:

  • To evaluate the association between lipoprotein(a) [Lp(a)] levels and the risk of coronary heart disease (CHD) events in women.
  • To investigate the combined effects of Lp(a) with fibrinogen and C-reactive protein on CHD risk.

Main Methods:

  • Analysis of data from 32,826 women in the Nurses' Health Study with 8 years of follow-up.
  • Case-control comparison using 228 CHD events and matched controls.
  • Multivariable logistic regression adjusted for various cardiovascular risk factors.

Main Results:

  • Elevated Lp(a) levels (≥30 mg/dL) were associated with a 1.9-fold increased odds ratio for CHD events (95% CI: 1.3-3.0).
  • High Lp(a) combined with high fibrinogen showed a 3.2-fold increased odds ratio for CHD (95% CI: 1.6-6.5).
  • High Lp(a) combined with high C-reactive protein showed a 3.67-fold increased odds ratio for CHD (95% CI: 2.03-6.64).

Conclusions:

  • Lipoprotein(a) levels above 30 mg/dL are linked to a doubled risk of CHD events in women.
  • These findings suggest a potential role for Lp(a) in the mechanisms of thrombosis and inflammation contributing to CHD.
Abstract

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