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Published on: October 12, 2017

Plasma lipoprotein(a) indicates risk for 4 distinct forms of vascular disease

Gregory T Jones1, Andre M van Rij, Jennifer Cole

  • 1Department of Medical and Surgical Sciences, University of Otago, Dunedin, New Zealand. greg.jones@otago.ac.nz

Clinical Chemistry
|February 17, 2007
PubMed

Insights

Elevated lipoprotein(a) [Lp(a)] is a significant risk factor for coronary artery disease and other vascular conditions. This study confirms Lp(a) poses a similar risk across four major vascular diseases, independent of other factors.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Chemistry
  • Genetics and Genomics

Background:

  • Elevated lipoprotein(a) [Lp(a)] is a known predictor of coronary artery disease (CAD).
  • The comparative risk of Lp(a) for other vascular diseases versus CAD has not been extensively studied in a single population.
  • This research investigates the association between Lp(a) and four distinct vascular diseases.

Purpose of the Study:

  • To determine the risk association of elevated lipoprotein(a) [Lp(a)] with coronary artery disease (CAD), peripheral vascular disease (PVD), ischemic stroke, and abdominal aortic aneurysm (AAA).
  • To compare the magnitude of risk conferred by Lp(a) across these four vascular conditions within a single study cohort.
  • To assess whether the Lp(a) risk association is influenced by confounding factors and lipid-lowering therapies.

Main Methods:

  • Plasma Lp(a) levels were measured using an Lp(a) ELISA in 384 CAD patients, 262 PVD patients, 184 ischemic stroke patients, 425 AAA patients, and 230 disease-free controls.
  • Association studies were conducted using logistic regression, adjusting for age, sex, diabetes, plasma lipids, and medical history (hypertension, hypercholesterolemia, smoking).
  • A clinical cutoff for Lp(a) was set at >45 nmol/L, representing the 75th percentile in controls.

Main Results:

  • Increased Lp(a) concentrations (>45 nmol/L) were identified as a significant risk factor for all four vascular disease groups studied.
  • Adjusted odds ratios for Lp(a) as a risk factor ranged from 1.96 for CAD to 2.33 for PVD.
  • The risk associated with Lp(a) was consistent across all disease groups and independent of confounders, including statin/fibrate therapy.

Conclusions:

  • Lipoprotein(a) [Lp(a)] is a stable risk factor of comparable magnitude for four major vascular diseases: CAD, PVD, ischemic stroke, and AAA.
  • The identified association between elevated Lp(a) and vascular disease risk was not modified by exposure to standard lipid-lowering treatments.
  • These findings underscore the importance of Lp(a) as a universal marker for vascular risk assessment.
Abstract

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