OBJECTIVE: To determine the association of serum levels of lipoprotein (a) (Lp(a)) with coronary artery disease (CAD) in relation to other risk factor variables in black and white women. DESIGN: Retrospective case-control study. SETTING: Community of Bogalusa, Louisiana and Cardiac Catheterization Laboratory at the Medical Center of Louisiana, New Orleans, USA. SUBJECTS: The study included 47 female cases (52% black; mean +/- SD age: 50.8 +/- 6.3 years) with confirmed myocardial infarction (MI) or at least 75% blockage of one or more major epicardial coronary arteries determined by angiography, and 55 controls (60% black; mean +/- SD age: 49.6 +/- 7.9 years) with no high grade obstructive lesion (< 50% blockage) and no history of CAD. MAIN OUTCOME MEASURES: Lipoprotein variables, homocysteine, body mass index and cigarette smoking. RESULTS: In the whole group, mean values of Lp(a), total cholesterol, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (apoB) and very-low-density lipoprotein cholesterol (VLDL-C) were higher (P < 0.05-0.001) and apoA-I was lower (P < 0.05) in cases than in controls. The multivariate logistic regression analysis showed elevated levels of Lp(a) (> 500 mg L-1) and LDL-C (> 3.36 mmol L-1) as strong independent risk factors, with odds ratios (with 95% confidence intervals) of 13.6 (4.00-46.30) and 4.64 (1.31-16.49), respectively. ApoA-I, with an odds ratio of 0.11 (0.02-0.64), was a protective factor only at high levels (> 53.6 mumol L-1). Between races, significant odds ratios were noted in the black women for Lp(a) (OR = 15.98; P < 0.01) and LDL-C (OR = 7.69; P < 0.05) and in the white women for only Lp(a) (OR = 15.23; P < 0.01). CONCLUSIONS: Lp(a) is an important risk factor for CAD both in black and in white women.
OBJECTIVE: To determine the association of serum levels of lipoprotein (a) (Lp(a)) with coronary artery disease (CAD) in relation to other risk factor variables in black and white women. DESIGN: Retrospective case-control study. SETTING: Community of Bogalusa, Louisiana and Cardiac Catheterization Laboratory at the Medical Center of Louisiana, New Orleans, USA. SUBJECTS: The study included 47 female cases (52% black; mean +/- SD age: 50.8 +/- 6.3 years) with confirmed myocardial infarction (MI) or at least 75% blockage of one or more major epicardial coronary arteries determined by angiography, and 55 controls (60% black; mean +/- SD age: 49.6 +/- 7.9 years) with no high grade obstructive lesion (< 50% blockage) and no history of CAD. MAIN OUTCOME MEASURES: Lipoprotein variables, homocysteine, body mass index and cigarette smoking. RESULTS: In the whole group, mean values of Lp(a), total cholesterol, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (apoB) and very-low-density lipoprotein cholesterol (VLDL-C) were higher (P < 0.05-0.001) and apoA-I was lower (P < 0.05) in cases than in controls. The multivariate logistic regression analysis showed elevated levels of Lp(a) (> 500 mg L-1) and LDL-C (> 3.36 mmol L-1) as strong independent risk factors, with odds ratios (with 95% confidence intervals) of 13.6 (4.00-46.30) and 4.64 (1.31-16.49), respectively. ApoA-I, with an odds ratio of 0.11 (0.02-0.64), was a protective factor only at high levels (> 53.6 mumol L-1). Between races, significant odds ratios were noted in the black women for Lp(a) (OR = 15.98; P < 0.01) and LDL-C (OR = 7.69; P < 0.05) and in the white women for only Lp(a) (OR = 15.23; P < 0.01). CONCLUSIONS:Lp(a) is an important risk factor for CAD both in black and in white women.
Authors: Atif N Qasim; Seth S Martin; Nehal N Mehta; Megan L Wolfe; James Park; Stanley Schwartz; Mark Schutta; Nayyar Iqbal; Muredach P Reilly Journal: Int J Cardiol Date: 2010-03-19 Impact factor: 4.164