BACKGROUND: On the basis of studies with limited statistical power, lipoprotein(a) [Lp(a)] is not considered a risk factor for cardiovascular disease (CVD) in blacks. We evaluated associations between Lp(a) and incident CVD events in blacks and whites in the Atherosclerosis Risk in Communities (ARIC) study. METHODS AND RESULTS: Plasma Lp(a) was measured in blacks (n=3467) and whites (n=9851). Hazards ratios (HRs) for incident CVD events (coronary heart disease and ischemic strokes) were calculated. Lp(a) levels were higher with wider interindividual variation in blacks (median [interquartile range], 12.8 [7.1-21.7] mg/dL) than whites (4.3 [1.7-9.5] mg/dL; P<0.0001). At 20 years of follow-up, 676 CVD events occurred in blacks, and 1821 events occurred in whites. Adjusted HRs (95% confidence interval) per race-specific 1-SD-greater log-transformed Lp(a) were 1.13 (1.04-1.23) for incident CVD, 1.11 (1.00-1.22) for incident coronary heart disease, and 1.21 (1.06-1.39) for ischemic strokes in blacks. For whites, the respective HRs (95% confidence intervals) were 1.09 (1.04-1.15), 1.10 (1.05-1.16), and 1.07 (0.97-1.19). Quintile analyses showed that risk for incident CVD was graded but statistically significant only for the highest compared with the lowest quintile (HR [95% confidence interval], 1.35 [1.06-1.74] for blacks and 1.27 [1.10-1.47] for whites). Similar results were obtained with the use of Lp(a) cutoffs of ≤10 mg/dL, >10 to ≤20 mg/dL, >20 to ≤30 mg/dL, and >30 mg/dL. CONCLUSIONS: Lp(a) levels were positively associated with CVD events. Associations were at least as strong, with a larger range of Lp(a) concentrations, in blacks compared with whites.
BACKGROUND: On the basis of studies with limited statistical power, lipoprotein(a) [Lp(a)] is not considered a risk factor for cardiovascular disease (CVD) in blacks. We evaluated associations between Lp(a) and incident CVD events in blacks and whites in the Atherosclerosis Risk in Communities (ARIC) study. METHODS AND RESULTS: Plasma Lp(a) was measured in blacks (n=3467) and whites (n=9851). Hazards ratios (HRs) for incident CVD events (coronary heart disease and ischemic strokes) were calculated. Lp(a) levels were higher with wider interindividual variation in blacks (median [interquartile range], 12.8 [7.1-21.7] mg/dL) than whites (4.3 [1.7-9.5] mg/dL; P<0.0001). At 20 years of follow-up, 676 CVD events occurred in blacks, and 1821 events occurred in whites. Adjusted HRs (95% confidence interval) per race-specific 1-SD-greater log-transformed Lp(a) were 1.13 (1.04-1.23) for incident CVD, 1.11 (1.00-1.22) for incident coronary heart disease, and 1.21 (1.06-1.39) for ischemic strokes in blacks. For whites, the respective HRs (95% confidence intervals) were 1.09 (1.04-1.15), 1.10 (1.05-1.16), and 1.07 (0.97-1.19). Quintile analyses showed that risk for incident CVD was graded but statistically significant only for the highest compared with the lowest quintile (HR [95% confidence interval], 1.35 [1.06-1.74] for blacks and 1.27 [1.10-1.47] for whites). Similar results were obtained with the use of Lp(a) cutoffs of ≤10 mg/dL, >10 to ≤20 mg/dL, >20 to ≤30 mg/dL, and >30 mg/dL. CONCLUSIONS:Lp(a) levels were positively associated with CVD events. Associations were at least as strong, with a larger range of Lp(a) concentrations, in blacks compared with whites.
Authors: J A Morrison; I deGroot; K A Kelly; M J Mellies; P Khoury; D Lewis; A Lewis; M Fiorelli; H A Tyroler; G Heiss; C J Glueck Journal: Metabolism Date: 1979-03 Impact factor: 8.694
Authors: S M Marcovina; J J Albers; A M Scanu; H Kennedy; F Giaculli; K Berg; R Couderc; F Dati; N Rifai; I Sakurabayashi; J R Tate; A Steinmetz Journal: Clin Chem Date: 2000-12 Impact factor: 8.327
Authors: Furcy Paultre; Catherine H Tuck; Bernadette Boden-Albala; Douglas E Kargman; Elizabeth Todd; Jeffrey Jones; Myunghee C Paik; Ralph L Sacco; Lars Berglund Journal: Arterioscler Thromb Vasc Biol Date: 2002-01 Impact factor: 8.311
Authors: F Paultre; T A Pearson; H F Weil; C H Tuck; M Myerson; J Rubin; C K Francis; H F Marx; E F Philbin; R G Reed; L Berglund Journal: Arterioscler Thromb Vasc Biol Date: 2000-12 Impact factor: 8.311
Authors: A R Sharrett; C M Ballantyne; S A Coady; G Heiss; P D Sorlie; D Catellier; W Patsch Journal: Circulation Date: 2001-09-04 Impact factor: 29.690
Authors: Børge G Nordestgaard; M John Chapman; Kausik Ray; Jan Borén; Felicita Andreotti; Gerald F Watts; Henry Ginsberg; Pierre Amarenco; Alberico Catapano; Olivier S Descamps; Edward Fisher; Petri T Kovanen; Jan Albert Kuivenhoven; Philippe Lesnik; Luis Masana; Zeljko Reiner; Marja-Riitta Taskinen; Lale Tokgözoglu; Anne Tybjærg-Hansen Journal: Eur Heart J Date: 2010-10-21 Impact factor: 29.983
Authors: Mark D Huffman; Namratha R Kandula; Abigail S Baldridge; Michael Y Tsai; Dorairaj Prabhakaran; Alka M Kanaya Journal: Am J Cardiol Date: 2018-12-19 Impact factor: 2.778
Authors: Anandita Agarwala; Salim Virani; David Couper; Lloyd Chambless; Eric Boerwinkle; Brad C Astor; Ron C Hoogeveen; Joe Coresh; A Richey Sharrett; Aaron R Folsom; Tom Mosley; Christie M Ballantyne; Vijay Nambi Journal: Atherosclerosis Date: 2016-08-25 Impact factor: 5.162
Authors: Brian T Steffen; Daniel Duprez; Alain G Bertoni; Weihua Guan; Michael Y Tsai Journal: Arterioscler Thromb Vasc Biol Date: 2018-10 Impact factor: 8.311