Stroke Research Today is a free monthly online journal that collates and summarizes the latest research about Stroke, including details on treatment, recovery, rehabilitation, signs, symptoms. | ||||||||
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Plasma lipoprotein(a) indicates risk for 4 distinct forms of vascular disease.Jones GT, van Rij AM, Cole J, Williams MJ, Bateman EH, Marcovina SM, Deng M, McCormick SP Department of Medical and Surgical Sciences, University of Otago, Dunedin, New Zealand. greg.jones@otago.ac.nz BACKGROUND: Increased lipoprotein(a) [Lp(a)] concentrations are predictive for coronary artery disease (CAD). The risk conferred by Lp(a) for other types of vascular disease compared with CAD has not been investigated within a single population. This study aimed to investigate Lp(a) risk association for 4 different types of vascular disease (including CAD) within a predominantly white population. METHODS: We used an Lp(a) ELISA that measures Lp(a) independently of apolipoprotein(a) size to measure plasma Lp(a) in patients [384 CAD, 262 peripheral vascular disease, 184 ischemic stroke (stroke), 425 abdominal aortic aneurysm] and 230 disease-free controls. We then conducted association studies with logistic regression, integrating the potential confounding effects of age, sex, diabetes, plasma lipids, and a history of previous hypertension, hypercholesterolemia, and smoking. RESULTS: Multivariate analyses with Lp(a) concentrations of >45 nmol/L (the 75th percentile value for controls) as the clinical cutoff showed increased Lp(a) concentrations to be a risk factor for all disease groups, with adjusted odds ratios ranging from 1.96 [95% confidence interval (CI) 1.24-3.08] for CAD to 2.33 (95% CI 1.39-3.89) for PVD. The risk conferred by Lp(a) appeared to be independent of other confounders, including exposure to statin/fibrate therapies. Similar odds ratios and CIs between disease groups indicated that increased Lp(a) conferred a similar risk for all groups studied. CONCLUSIONS: Lp(a) constitutes a stable risk factor of similar magnitude for 4 major forms of vascular disease. This association was not altered by exposure to standard lipid-lowering therapy. Published 4 April 2007 in Clin Chem, 53(4): 679-85.
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