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. 2012 Dec;32(12):3058-65.
doi: 10.1161/ATVBAHA.112.255521. Epub 2012 Oct 11.

Lipoprotein(a) and risk of coronary, cerebrovascular, and peripheral artery disease: the EPIC-Norfolk prospective population study

Deepti Gurdasani  1 , Barbara Sjouke, Sotirios Tsimikas, G Kees Hovingh, Robert N Luben, Nicholas W J Wainwright, Cristina Pomilla, Nicholas J Wareham, Kay-Tee Khaw, S Matthijs Boekholdt, Manjinder S Sandhu
Affiliations

Lipoprotein(a) and risk of coronary, cerebrovascular, and peripheral artery disease: the EPIC-Norfolk prospective population study

Deepti Gurdasani et al. Arterioscler Thromb Vasc Biol. 2012 Dec.

Abstract

Objective: Although the association between circulating levels of lipoprotein(a) [Lp(a)] and risk of coronary artery disease (CAD) and stroke is well established, its role in risk of peripheral arterial disease (PAD) remains unclear. Here, we examine the association between Lp(a) levels and PAD in a large prospective cohort. To contextualize these findings, we also examined the association between Lp(a) levels and risk of stroke and CAD and studied the role of low-density lipoprotein as an effect modifier of Lp(a)-associated cardiovascular risk.

Methods and results: Lp(a) levels were measured in apparently healthy participants in the European Prospective Investigation of Cancer (EPIC)-Norfolk cohort. Cox regression was used to quantify the association between Lp(a) levels and risk of PAD, stroke, and CAD outcomes. During 212 981 person-years at risk, a total of 2365 CAD, 284 ischemic stroke, and 596 PAD events occurred in 18 720 participants. Lp(a) was associated with PAD and CAD outcomes but not with ischemic stroke (hazard ratio per 2.7-fold increase in Lp(a) of 1.37, 95% CI 1.25-1.50, 1.13, 95% CI 1.04-1.22 and 0.91, 95% CI 0.79-1.03, respectively). Low-density lipoprotein cholesterol levels did not modify these associations.

Conclusions: Lp(a) levels were associated with future PAD and CAD events. The association between Lp(a) and cardiovascular disease was not modified by low-density lipoprotein cholesterol levels.

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Figures

Figure 1
Figure 1. Non-linearity of the association between Lp(a) and risk of peripheral artery disease
Adjusted hazard ratios and corresponding 95% confidence intervals by sex-specific quartiles of Lp(a).
Figure 2
Figure 2. Non-linearity of the association between Lp(a) and risk of coronary artery disease
Adjusted hazard ratios and corresponding 95% confidence intervals by sex-specific quartiles of Lp(a).
Figure 3
Figure 3. Hazard ratio for coronary artery disease as a function of time
See this image and copyright information in PMC

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