Lipoprotein(a) and Risk of Coronary, Cerebrovascular, and Peripheral Artery Disease
Key result
Lipoprotein(a) levels were associated with a 37% increased risk of peripheral artery disease and coronary artery disease but not with ischemic stroke.
Why the study?
Does elevated Lipoprotein(a) increase the risk of peripheral arterial disease, coronary artery disease, and stroke in apparently healthy individuals?
Population
Apparently healthy participants in the European Prospective Investigation of Cancer (EPIC)-Norfolk cohort
Design
Cohort
Follow-up
212 981 person-years at risk
Authors
Discussion
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Member takes
Implication
Lp(a) assessment may refine primary-prevention risk stratification for PAD and CAD; extends prior associations while leaving stroke risk open.
Key Points
- To assess the prospective association between circulating lipoprotein(a) levels and the risk of peripheral arterial disease, coronary artery disease, and stroke, and evaluate low-density lipoprotein cholesterol as an effect modifier.
- Measured baseline lipoprotein(a) and low-density lipoprotein cholesterol in 18,720 apparently healthy participants from the prospective EPIC-Norfolk cohort followed for 212,981 person-years.
- Used Cox proportional hazards regression to model associations between circulating lipoprotein(a) levels and incident peripheral arterial disease, coronary artery disease, and stroke.
- A total of 2,365 coronary artery disease, 596 peripheral arterial disease, and 284 ischemic stroke events occurred during follow-up across 18,720 participants.
- Per 2.7-fold increase in lipoprotein(a), the hazard ratio was 1.37 (95% CI, 1.25–1.50) for peripheral arterial disease, 1.13 (95% CI, 1.04–1.22) for coronary artery disease, and 0.91 (95% CI, 0.79–1.03) for ischemic stroke.
- Low-density lipoprotein cholesterol levels did not modify the cardiovascular disease risk associated with lipoprotein(a).
Structured PICO
Does elevated Lipoprotein(a) increase the risk of peripheral arterial disease, coronary artery disease, and stroke in apparently healthy individuals?
P
Population
Apparently healthy participants in the European Prospective Investigation of Cancer (EPIC)-Norfolk cohort
I
Intervention
Elevated Lipoprotein(a) levels
O
Outcome
Incident peripheral arterial disease (PAD), coronary artery disease (CAD), and ischemic strokehard clinical
Elevated Lipoprotein(a) is an independent risk factor for future peripheral artery disease and coronary artery disease events, and this risk is not modified by LDL cholesterol levels.
Cite This Study
Gurdasani et al. (2012) studied this question. Lipoprotein(a) levels were associated with a 37% increased risk of peripheral artery disease and coronary artery disease but not with ischemic stroke.