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A prospective study of lipoprotein(a) and the risk of myocardial infarction

P M Ridker1, C H Hennekens, M J Stampfer

  • 1Department of Medicine, Brigham and Women's Hospital, Boston, MA 02215-1204.

JAMA
|November 10, 1993
PubMed

Insights

Elevated lipoprotein(a) [Lp(a)] levels did not increase myocardial infarction risk in middle-aged men. This study suggests Lp(a) is not a reliable screening tool for cardiovascular risk in this population.

Area of Science:

  • Cardiovascular Medicine
  • Lipidology
  • Preventive Cardiology

Background:

  • Lipoprotein(a) [Lp(a)] is an emerging cardiovascular risk factor.
  • Previous studies have yielded conflicting results regarding the association between Lp(a) and myocardial infarction (MI).

Purpose of the Study:

  • To prospectively evaluate the association between elevated lipoprotein(a) levels and the risk of developing myocardial infarction (MI).

Main Methods:

  • A nested case-control study was conducted within the Physicians' Health Study.
  • 14,916 male physicians without prior MI or stroke provided baseline plasma samples.
  • Follow-up averaged 60.2 months, with Lp(a) levels analyzed in 296 MI cases and matched controls.

Main Results:

  • No significant difference in Lp(a) levels was observed between MI cases and controls (median 103.0 mg/L vs 102.5 mg/L, P = .73).
  • Analyses controlling for age, smoking, and other cardiovascular risk factors showed no association between Lp(a) levels and MI risk (P for trend = .93).
  • No threshold effect was identified at various Lp(a) cutoff levels.

Conclusions:

  • This prospective study found no evidence linking lipoprotein(a) levels to an increased risk of future myocardial infarction in predominantly middle-aged white men.
  • The findings do not support the use of Lp(a) as a screening tool for cardiovascular risk assessment in this demographic.
Abstract

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