Related Experiment Videos
Apolipoprotein(a) isoforms and coronary heart disease in men: a nested case-control study
I C Klausen1, A Sjøl, P S Hansen
1Department of Internal Medicine and Cardiology A, Aarhus Amtesygehus University Hospital, Aarhus C, Denmark.
Atherosclerosis
|July 11, 1997
Summary
Low molecular weight (LMW) apolipoprotein(a) (apo(a)) isoforms are linked to increased coronary heart disease (CHD) risk in men under 60. This finding highlights the importance of specific apo(a) isoforms in cardiovascular risk assessment for younger men.
Area of Science:
- Cardiovascular Science
- Lipid Metabolism
- Genetic Epidemiology
Background:
- Coronary heart disease (CHD) remains a leading cause of mortality worldwide.
- Lipoprotein(a) [Lp(a)] is an established risk factor for CHD, but the role of specific apolipoprotein(a) [apo(a)] isoforms is less understood.
- Low molecular weight (LMW) apo(a) isoforms have been hypothesized to be more atherogenic.
Purpose of the Study:
- To investigate the association between LMW apo(a) isoforms (F, B, S1, S2) and the risk of developing coronary heart disease (CHD).
- To determine if this association is modified by age, particularly in men under 60 years.
Main Methods:
- A nested case-control study was conducted using data from five cohorts of white men.
- Plasma samples from cases (myocardial infarction or angina pectoris) and matched controls were analyzed for Lp(a) levels and apo(a) isoform size.
- Conditional logistic regression models were used to assess the association between LMW apo(a) isoforms, Lp(a) levels, and CHD risk, adjusting for traditional risk factors.
Main Results:
- In the overall cohort, Lp(a) levels interacted significantly with age, with high Lp(a) (>45 mg/dl) associated with increased CHD risk only in men under 60.
- Among men under 60 years, the presence of LMW apo(a) isoforms was a significant predictor of CHD development (OR = 3.83).
- High Lp(a) levels (OR = 3.68) and LMW apo(a) isoforms were independently associated with increased CHD risk in younger men, alongside cholesterol, systolic blood pressure, and smoking.
Conclusions:
- LMW apo(a) isoforms are significantly associated with an increased risk of CHD in men under 60 years.
- These findings suggest that apo(a) isoform size may be an important determinant of Lp(a) pathogenicity, particularly in younger individuals.
- The study underscores the need to consider apo(a) isoform analysis in cardiovascular risk stratification, especially for younger men.