Lipoprotein (a) and coronary heart disease among women: beyond a cholesterol carrier?
OBJECTIVE
With its homology with plasminogen, lipoprotein(a) [Lp(a)] may be related to thrombosis and inflammation. We assessed the role of Lp(a) in coronary heart diseases (CHD) by a recently developed assay that is not affected by the plasminogen-like Kringle-type-2 repeats.


RESULTS
Of 32 826 women from the Nurses' Health Study, who provided blood at baseline, we documented 228 CHD events during 8 years of follow-up. Each case was compared with two matched controls. In a multivariable model adjusted for body mass index, family history, hypertension, diabetes, post-menopausal hormone use, physical activity, blood drawing characteristics, and alcohol intake, the odd ratio (OR) for Lp(a) levels > or =30 mg/dL was 1.9(95% CI: 1.3-3.0) when compared with those with Lp(a)<30 mg/dL. Women with high levels of both Lp(a) (> or =30 mg/dL) and fibrinogen (> or =400 mg/dL) had an OR of 3.2(95% CI: 1.6-6.5) for CHD, when compared with the combination of low levels (P interaction=0.05). Women with high levels of both Lp(a) and C-reactive protein (> or =3 mg/L) had an OR of 3.67(95% CI: 2.03-6.64) for CHD, when compared with the combination of low levels (P interaction=0.06).


CONCLUSIONS
Lp(a) levels >30 mg/dL are associated with twice the risk of CHD events among women and may be related to thrombosis and inflammation.
Shai
Iris
I
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. ishai@hsph.harvard.edu
Rimm
Eric B
EB
Hankinson
Susan E
SE
Cannuscio
Carolyn
C
Curhan
Gary
G
Manson
JoAnn E
JE
Rifai
Nader
N
Stampfer
Meir J
MJ
Ma
Jing
J
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000097:blood*; D003327:Coronary Disease / Q000097:blood / Q000175:diagnosis*; D004812:Epidemiologic Methods; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D008875:Middle Aged
D015415:Biomarkers; D017270:Lipoprotein(a); D005340:Fibrinogen; D002097:C-Reactive Protein; D002784:Cholesterol