October 1, 1994Circulation
A prospective investigation of elevated lipoprotein (a) detected by electrophoresis and cardiovascular disease in women. The Framingham Heart Study.
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Discussion
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Implication
Prospective cohort study demonstrates elevated lipoprotein(a) increases cardiovascular disease risk in women, indicating its clinical utility as an independent prognostic marker.
Key Points
- To examine whether elevated lipoprotein(a) levels, identified by the presence of a sinking prebeta lipoprotein band, independently predict cardiovascular disease risk in women.
- Prospective cohort evaluation of 3,103 women without prevalent cardiovascular disease in the Framingham Heart Study, followed for a median duration of approximately 12 years.
- Paper electrophoresis was used to identify sinking prebeta lipoprotein bands, with multivariable proportional hazards models adjusting for age, blood pressure, BMI, smoking, glucose intolerance, cholesterol fractions, and left ventricular hypertrophy.
- A sinking prebeta lipoprotein band was present in 434 women (14%) and demonstrated 50.9% sensitivity and 95.4% specificity for plasma lipoprotein(a) levels exceeding 30 mg/dL.
- Band presence significantly increased the multivariable-adjusted relative risk of myocardial infarction (82 events; RR 2.37, 95% CI 1.48–3.81), intermittent claudication (62 events; RR 1.94, 95% CI 1.07–3.50), and cerebrovascular disease (83 events; RR 1.88, 95% CI 1.12–3.15).
- Band presence was also associated with total coronary heart disease (174 events; RR 1.61, 95% CI 1.13–2.29) and total cardiovascular disease (305 events; RR 1.44, 95% CI 1.09–1.91).
Cite This Study
Bostom et al. (1994) studied this question.