In this cohort of 9936 men and women initially free of cardiovascular disease who were followed up for 14 years, Lp(a) was a significant predictor of risk of future CAD. Lp(a) was a weak risk factor for CVD in men and was not a significant predictor of CVD risk in women.

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SUMMARY Stepwise linear discrimination was used to analyze risk factors in 431 consecutive patients who underwent coronary angiography to determine which variables were most closely associated with coronary artery disease. Twenty-one risk factors were considered: total plasma cholesterol and triglycerides; the cholesterol and triglyceride content of high-density lipoproteins (HDL), low-density lipoproteins (LDL) and very low density lipoproteins (VLDL); and the percentage of total cholesterol and triglycerides in each fraction. Age, smoking history, family history, hypertension, diabetes mellitus and relative weight were also considered. Coronary artery disease was assessed using three standard grading scores. There were significant differences in risk factors between males and females. In males, LDL cholesterol and age were selected by multivariate analysis. In females, the ratio of HDL cholesterol to total cholesterol, as well as relative weight, family history, age and smoking were selected. The discriminating value of HDL cholesterol as the percentage of total cholesterol was significantly greater than that of HDL cholesterol itself. Despite highly significant associations between risk factors and the presence of coronary artery disease, the discrimination did not provide sufficient separation of the groups to give results that are useful diagnostically in individual patients.THE RELATIONSHIP between hyperlipidemia and an increased risk of coronary heart disease has been well documented and has served as a motivating factor for research into lipoprotein structure, function and metabolism. The aim of the research has been to isolate lipoprotein factors that are most closely associated with coronary heart disease in order to gain some knowledge about the pathophysiology of atherosclerosis and to allow clinicians to identify persons who are at high risk of developing the disease. Although Barr et al.' reported in 1951 the inverse relationship between high-density lipoproteins (HDL) and the incidence of coronary heart disease, until recently most attention has been directed at two of the principal carriers of plasma cholesterol, very low density (VLDL) and low-density (LDL) lipoproteins.During the past several years, however, the importance of HDL has been widely recognized,2 9 and in some studies, HDL appears to have been most predictive of coronary artery disease.10 Those findings support experimental evidence that HDL may have a role in inhibiting the accumulation of cholesterol in arteries by promoting the removal of cellular cholesterol."1-3 Other risk factors, including family history, hypertension, tobacco abuse, age, sex and diabetes also have been found to be associated with an increased risk of coronary artery disease.'4-16 Limited information is available concerning the predictive value of these variables and their relationship to angiographically defined coronary artery disease.6 ', 17-19 The purpose of this study was to determine the relationship between angiographically defined coronary artery ...