| Lipoprotein(a) levels and long-term cardiovascular risk in the contemporary era of statin therapy. | |
| | |
MedLine Citation:
|
PMID: 20601648 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Lipoprotein(a) [Lp(a)] has enhanced atherothrombotic properties. The ability of Lp(a) levels to predict adverse cardiovascular outcomes in patients undergoing coronary angiography has not been examined. The relationship between serum Lp(a) levels and both the extent of angiographic disease and 3-year incidence of major adverse cardiovascular events (MACE: death, myocardial infarction, stroke, and coronary revascularization) was investigated in 2,769 patients who underwent coronary angiography [median Lp(a) 16.4 mg/dl, elevated levels (≥30 mg/dl) in 38%]. An elevated Lp(a) was associated with a 2.3-fold [95% confidence interval (CI), 1.7-3.2, P < 0.001] greater likelihood of having a significant angiographic stenosis and 1.5-fold (95 CI, 1.3-1.7, P < 0.001) greater chance of three-vessel disease. Lp(a)≥30 mg/dl was associated with a greater rate of MACE (41.8 vs. 35.8%, P = 0.005), primarily due to a greater need for coronary revascularization (30.9 vs. 26.0%, P = 0.02). A relationship between Lp(a) levels and cardiovascular outcome was observed in patients with an LDL cholesterol (LDL-C) ≥70-100 mg/dl (P = 0.049) and >100 mg/dl (P = 0.02), but not <70 mg/dl (P = 0.77). Polymorphisms of Lp(a) were also associated with both plasma Lp(a) levels and coronary stenosis, but not a greater rate of MACE. Lp(a) levels correlate with the extent of obstructive disease and predict the need for coronary revascularization in subjects with suboptimal LDL-C control. This supports the need to intensify lipid management in patients with elevated Lp(a) levels. |
| | |
Authors:
|
Stephen J Nicholls; W H Wilson Tang; Heather Scoffone; Danielle M Brennan; Jaana Hartiala; Hooman Allayee; Stanley L Hazen |
Related Documents
:
|
16872968 - Preoperative statin therapy is associated with reduced cardiac mortality after coronary... 19630828 - Testing the inflammatory hypothesis of atherothrombosis: scientific rationale for the c... 3055918 - Therapeutic control of hyperlipidemia in the prevention of coronary atherosclerosis: a ... 11505078 - Seasonal variation of some metabolic and haemostatic risk factors in subjects with and ... 10084378 - A patient with hypertrophic cardiomyopathy accompanied by right ventricular dilation of... 2595728 - Nonvalvular atrial fibrillation as a cause of fatal massive cerebral infarction in the ... |
Publication Detail:
|
Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-07-02 |
Journal Detail:
|
Title: Journal of lipid research Volume: 51 ISSN: 0022-2275 ISO Abbreviation: J. Lipid Res. Publication Date: 2010 Oct |
Date Detail:
|
Created Date: 2010-09-10 Completed Date: 2011-01-24 Revised Date: 2012-05-07 |
Medline Journal Info:
|
Nlm Unique ID: 0376606 Medline TA: J Lipid Res Country: United States |
Other Details:
|
Languages: eng Pagination: 3055-61 Citation Subset: IM |
Affiliation:
|
Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA. nichols1@ccf.org |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Cardiovascular Diseases / complications, drug therapy*, epidemiology* Cholesterol, LDL / blood Female Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use* Lipoprotein(a) / blood* Male Polymorphism, Genetic Risk Factors |
| Grant Support | |
ID/Acronym/Agency:
|
1P01 HL098055-01/HL/NHLBI NIH HHS; 1R01 DK080732-01A1/DK/NIDDK NIH HHS; 1R01 HL103931-01/HL/NHLBI NIH HHS; P01 HL087018-020001/HL/NHLBI NIH HHS; P50 HL077107-050004/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Cholesterol, LDL; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Lipoprotein(a) |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The relationship between inflammatory markers and post stroke cognitive impairment.
Next Document: Genetic, epigenetic, and gene-by-diet interaction effects underlie variation in serum lipids in a LG...