TY - JOUR
T1 - Plasma lipoprotein(a) concentration predicts future coronary and cardiovascular events in patients with stable coronary heart disease
AU - Nestel, Paul J
AU - Barnes, Elizabeth
AU - Tonkin, Andrew Maxwell
AU - Simes, John
AU - Fournier, Marion
AU - White, Harvey D
AU - Colquhoun, David
AU - Blankenberg, Stefan
AU - Sullivan, David
PY - 2013
Y1 - 2013
N2 - Association between lipoprotein(a) (Lp(a)) level and a first-ever coronary (CHD) event is recognized. Less is evident
in patients with overt CHD and stable symptoms in whom we investigated associations between Lp(a) and future events.
Approach and Results?Relationships between Lp(a) concentration and CHD and cardiovascular disease outcomes during
6 years? median follow-up were evaluated in the Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID)
study. Lp(a) concentrations were measured in plasma from 7863 patients who had sustained a previous coronary event
and been randomized to pravastatin or placebo. Lp(a) levels were categorized by lowest half, third quartile, 75th to 90th
percentile, and highest decile. The prognostic value of Lp(a) on outcomes was assessed by fitting a Cox proportionalhazards
model after adjustment for other risk factors and baseline cardiovascular disorders. The prognostic value of a
change in Lp(a) at year 1 categorized by quartiles was assessed using Cox regression in a landmark model incorporating
the above factors and baseline levels. Baseline Lp(a) concentration was associated with total CHD events (P73 mg/dL, upper
decile. For events after year 1, an increase in Lp(a) at 1 year was associated with adverse outcomes for total CHD events
and total cardiovascular disease events (P=0.002 each).
Conclusions?In the LIPID study, baseline Lp(a) was associated with future cardiovascular disease and CHD events.
Increased Lp(a) concentrations after 1 year were also associated with future events, supporting measurement of Lp(a) for
risk assessment of patients with known CHD.
AB - Association between lipoprotein(a) (Lp(a)) level and a first-ever coronary (CHD) event is recognized. Less is evident
in patients with overt CHD and stable symptoms in whom we investigated associations between Lp(a) and future events.
Approach and Results?Relationships between Lp(a) concentration and CHD and cardiovascular disease outcomes during
6 years? median follow-up were evaluated in the Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID)
study. Lp(a) concentrations were measured in plasma from 7863 patients who had sustained a previous coronary event
and been randomized to pravastatin or placebo. Lp(a) levels were categorized by lowest half, third quartile, 75th to 90th
percentile, and highest decile. The prognostic value of Lp(a) on outcomes was assessed by fitting a Cox proportionalhazards
model after adjustment for other risk factors and baseline cardiovascular disorders. The prognostic value of a
change in Lp(a) at year 1 categorized by quartiles was assessed using Cox regression in a landmark model incorporating
the above factors and baseline levels. Baseline Lp(a) concentration was associated with total CHD events (P73 mg/dL, upper
decile. For events after year 1, an increase in Lp(a) at 1 year was associated with adverse outcomes for total CHD events
and total cardiovascular disease events (P=0.002 each).
Conclusions?In the LIPID study, baseline Lp(a) was associated with future cardiovascular disease and CHD events.
Increased Lp(a) concentrations after 1 year were also associated with future events, supporting measurement of Lp(a) for
risk assessment of patients with known CHD.
UR - http://atvb.ahajournals.org/content/early/2013/10/03/ATVBAHA.113.302479.full.pdf+html
U2 - 10.1161/ATVBAHA.113.302479
DO - 10.1161/ATVBAHA.113.302479
M3 - Article
SN - 1079-5642
VL - 33
SP - 2902
EP - 2908
JO - Arteriosclerosis, Thrombosis, and Vascular Biology
JF - Arteriosclerosis, Thrombosis, and Vascular Biology
IS - 12
ER -
