AIMS: 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. METHODS AND 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). CONCLUSION: 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.
AIMS: 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. METHODS AND 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). CONCLUSION: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.
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Authors: J Danesh; S Erqou; M Walker; S G Thompson; R Tipping; C Ford; S Pressel; G Walldius; I Jungner; A R Folsom; L E Chambless; M Knuiman; P H Whincup; S G Wannamethee; R W Morris; J Willeit; S Kiechl; P Santer; A Mayr; N Wald; S Ebrahim; D A Lawlor; J W G Yarnell; J Gallacher; E Casiglia; V Tikhonoff; P J Nietert; S E Sutherland; D L Bachman; J E Keil; M Cushman; B M Psaty; R P Tracy; A Tybjaerg-Hansen; B G Nordestgaard; R Frikke-Schmidt; S Giampaoli; L Palmieri; S Panico; D Vanuzzo; L Pilotto; L Simons; J McCallum; Y Friedlander; F G R Fowkes; A J Lee; F B Smith; J Taylor; J Guralnik; C Phillips; R Wallace; D Blazer; K T Khaw; J H Jansson; C Donfrancesco; V Salomaa; K Harald; P Jousilahti; E Vartiainen; M Woodward; R B D'Agostino; P A Wolf; R S Vasan; M J Pencina; E M Bladbjerg; T Jorgensen; L Moller; J Jespersen; R Dankner; A Chetrit; F Lubin; A Rosengren; L Wilhelmsen; G Lappas; H Eriksson; C Bjorkelund; P Cremer; D Nagel; R Tilvis; T Strandberg; B Rodriguez; L M Bouter; R J Heine; J M Dekker; G Nijpels; C D A Stehouwer; E Rimm; J Pai; S Sato; H Iso; A Kitamura; H Noda; U Goldbourt; V Salomaa; J T Salonen; K Nyyssönen; T-P Tuomainen; D Deeg; J L Poppelaars; T Meade; J Cooper; B Hedblad; G Berglund; G Engstrom; A Döring; W Koenig; C Meisinger; W Mraz; L Kuller; R Selmer; A Tverdal; W Nystad; R Gillum; M Mussolino; S Hankinson; J Manson; B De Stavola; C Knottenbelt; J A Cooper; K A Bauer; R D Rosenberg; S Sato; Y Naito; I Holme; H Nakagawa; H Miura; P Ducimetiere; X Jouven; C Crespo; M Garcia-Palmieri; P Amouyel; D Arveiler; A Evans; J Ferrieres; H Schulte; G Assmann; J Shepherd; C Packard; N Sattar; B Cantin; B Lamarche; J-P Després; G R Dagenais; E Barrett-Connor; D Wingard; R Bettencourt; V Gudnason; T Aspelund; G Sigurdsson; B Thorsson; M Trevisan; J Witteman; I Kardys; M Breteler; A Hofman; H Tunstall-Pedoe; R Tavendale; G D O Lowe; Y Ben-Shlomo; B V Howard; Y Zhang; L Best; J Umans; A Onat; T W Meade; I Njolstad; E Mathiesen; M L Lochen; T Wilsgaard; J M Gaziano; M Stampfer; P Ridker; H Ulmer; G Diem; H Concin; F Rodeghiero; A Tosetto; E Brunner; M Shipley; J Buring; S M Cobbe; I Ford; M Robertson; Y He; A M Ibanez; E J M Feskens; D Kromhout; R Collins; E Di Angelantonio; S Kaptoge; S Lewington; L Orfei; L Pennells; P Perry; K Ray; N Sarwar; M Scherman; A Thompson; S Watson; F Wensley; I R White; A M Wood Journal: Eur J Epidemiol Date: 2007-09-18 Impact factor: 8.082