Lipoprotein(a) is an independent risk factor for cardiovascular disease in heterozygous familial hypercholesterolemia.

TitleLipoprotein(a) is an independent risk factor for cardiovascular disease in heterozygous familial hypercholesterolemia.
Publication TypeJournal Article
Year of Publication2005
AuthorsHolmes, DT, Schick, BA, Humphries, KH, Frohlich, J
JournalClin Chem
Volume51
Issue11
Pagination2067-73
Date Published2005 Nov
ISSN0009-9147
KeywordsAdolescent, Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Heterozygote, Humans, Hyperlipoproteinemia Type II, Hypertension, Lipoprotein(a), Male, Middle Aged, Multivariate Analysis, Regression Analysis, Retrospective Studies, Risk Factors, Sex Factors, Smoking
Abstract

BACKGROUND: The role of lipoprotein(a) [Lp(a)] as a predictor of cardiovascular disease (CVD) in patients with heterozygous familial hypercholesterolemia (HFH) is unclear. We sought to examine the utility of this lipoprotein as a predictor of CVD outcomes in the HFH population at our lipid clinic.METHODS: This was a retrospective analysis of clinical and laboratory data from a large multiethnic cohort of HFH patients at a single, large lipid clinic in Vancouver, Canada. Three hundred and eighty-eight patients were diagnosed with possible, probable, or definite HFH by strict clinical diagnostic criteria. Multivariate Cox regression analysis was used to study the relationship between several established CVD risk factors, Lp(a), and the age of first hard CVD event.RESULTS: An Lp(a) concentration of 800 units/L (560 mg/L) or higher was a significant independent risk factor for CVD outcomes [hazard ratio (HR) = 2.59; 95% confidence interval (CI), 1.53-4.39; P < 0.001]. Other significant risk factors were male sex [HR = 3.19 (1.79-5.69); P < 0.001] and ratio of total to HDL-cholesterol [1.18 (1.07-1.30); P = 0.001]. A previous history of smoking or hypertension each produced HRs consistent with increased CVD risk [HR = 1.55 (0.92-2.61) and 1.57 (0.90-2.74), respectively], but neither reached statistical significance (both P = 0.10). LDL-cholesterol was not an independent predictor of CVD risk [HR = 0.85 (0.0.71-1.01); P = 0.07], nor was survival affected by the subcategory of HFH diagnosis (i.e., possible vs probable vs definite HFH).CONCLUSION: Lp(a) is an independent predictor of CVD risk in a multiethnic HFH population.

DOI10.1373/clinchem.2005.055228
Alternate JournalClin. Chem.
PubMed ID16141286