The prevalence of increased lipoprotein (a) in the Czech general population and in patients with coronary heart disease

BACKGROUND: Lipoprotein(a) (Lp(a)) is a cardiovascular risk factor (RF) with potentially high clinical impact. However, in the "real world", it remains largely overlooked, and the epidemiological circumstances of this RF have not yet been systematically studied in the Czech population. The aim of this study was to determine the prevalence of elevated values in cardiovascular patients and in the general population of this country. METHODS: A descriptive survey and case-control study were conducted on 2001 subjects [mean age 61.5 years (±SD 12.5); 62.9% males], 1016 cases-patients with manifest coronary heart disease, (CHD), and 985 controls-a random general population sample. RESULTS: The CHD patients had a significantly higher prevalence of increased Lp(a) (≥125 nmol/L) than the control group (25.1 vs 12.9%, P<0.0001). We found a similar relative difference using a lower cut-off, i.e., Lp(a) ≥105 nmol/L (28.9 vs. 14.6%, P<0.0001). In case-control analysis, fully adjusted odds ratio for Lp(a) ≥125 nmol/L was 1.69 (95%CI: 1.13-2.53, P=0.011), while for Lp(a) ≥105 nmol/L, 1.71 (95%CI: 1.16-2.52, P=0.006). Increased Lp(a) was also independent of other conventional RFs, and the only major coincidence we found was elevated LDL cholesterol. CONCLUSIONS: This study showed a significantly higher prevalence of Lp(a) in patients with manifest CHD compared to the general population. The systematic screening of this RF and pharmacologic intervention are probably warranted in routine clinical practice.