Lipoprotein Lp(a) and the risk for myocardial infarction

Kostner, Gert M.; Avogaro, P; Cazzolato, G.; Marth, Egon; Bittolo-Bon, Gabriele; Qunici, G.B.

doi:10.1016/0021-9150(81)90103-9

Cited by 664 publications

(247 citation statements)

References 11 publications

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“…These results agree with those of Cobbaert and Kesteloot (1992), Guyton et al, (1985), Kostner et al, (1981) and Parra et al, (1987). Also, the lack of a relationship of Lp(a) concentration with age is in agreement with the findings of Heinrich et al, (1991) and Steinmetz et al (1993).…”

Section: Discussionsupporting

confidence: 91%

Factors contributing to variation in lipoprotein (a) in Melbourne Anglo-Celtic population

et al. 2003

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Aim: The purpose of this report is to survey the factors contributing to variation in lipoprotein(a) (Lp(a)) in a population-based sample of Anglo-Celtic Melburnians. Results: The plasma Lp(a) levels were highly skewed towards low levels in this population, with a median of 156 mg=l and a mean of 262 mg=l. Approximately 33% had plasma Lp(a) above the threshold value of 300 mg=l, while 35% had Lp(a) levels below 100 mg=l. The most commonly occurring phenotype was apo(a) S3. In this phenotype, Lp(a) concentrations ranged from 10 to 596 mg=l. Lp(a) was consistently associated with diastolic blood pressure, systolic blood pressure, total protein, albumin and nitrogen excretion in the 40 -60 y age group. Multiple stepwise regression analyses, in non-dietary factors, were used to explain about 13% of the variance in Lp(a) (19% in men and 23% in women). Remarkably, in the <40 y age group, non-dietary factors may account for 86% of the variance in Lp(a) and dietary factors, analysed separately, 46%. Thus, although Lp(a) is mainly genetically determined, there are clearly other factors which contribute to variations in Lp(a) concentrations.

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Section: Discussionsupporting

confidence: 91%

Factors contributing to variation in lipoprotein (a) in Melbourne Anglo-Celtic population

et al. 2003

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“…Despite intensive work in numerous laboratories, the physiological role of Lp(a) remains elusive. Concerning the pathophysiology of Lp(a), there are numerous reports that an elevated plasma concentration of Lp(a) (above 25-30 mg dL ÿ 1 ) is strongly associated with myocardial infarction, peripheral vascular diseases and stroke [5][6][7][8][9][10][11]. In addition, Lp(a) is considered to be a prothrombotic lipoprotein [12].…”

Section: Introductionmentioning

confidence: 99%

The assembly of lipoprotein Lp(a)

Frank¹,

Durovic²,

Kostner³

1996

Eur J Clin Investigation

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“…26 Elevated Lp(a) levels were defined as Ն30 mg/dL (Ն72 nmol/L). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][17][18][19][20][21][22][23][24] …”

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confidence: 99%

“…[1][2][3] In numerous, but not all, prospective studies, mainly in white populations, elevations of plasma Lp(a) levels, usually defined as Ն30 mg/dL, were significantly correlated with coronary artery disease (CAD). 4 -13 Curiously, although mean Lp(a) levels are twice as high in African Americans compared with whites, studies to date have failed to establish a significant association between elevated Lp(a) levels (Ն30 mg/dL) and CAD among African Americans.…”

mentioning

confidence: 99%

High Levels of Lp(a) With a Small Apo(a) Isoform Are Associated With Coronary Artery Disease in African American and White Men

Paultre

Pearson

Weil

et al. 2000

ATVB

160

132

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Abstract-Elevated levels of lipoprotein(a) [Lp(a)] and the presence of small isoforms of apolipoprotein(a) [apo(a)] have been associated with coronary artery disease (CAD) in whites but not in African Americans. Because of marked race/ethnicity differences in the distribution of Lp(a) levels across apo(a) sizes, we tested the hypothesis that apo(a) isoform size determines the association between Lp(a) and CAD. We related Lp(a) levels, apo(a) isoforms, and the levels of Lp(a) associated with different apo(a) isoforms to the presence of CAD (Ն50% stenosis) in 576 white and African American men and women. Only in white men were Lp(a) levels significantly higher among patients with CAD than in those without CAD (28.4 versus 16.5 mg/dL, respectively; Pϭ0.004), and only in this group was the presence of small apo(a) isoforms (Ͻ22 kringle 4 repeats) associated with CAD (Pϭ0.043). Elevated Lp(a) levels (Ն30 mg/dL) were found in 26% of whites and 68% of African Americans, and of those, 80% of whites but only 26% of African Americans had a small apo(a) isoform. Elevated Lp(a) levels with small apo(a) isoforms were significantly associated with CAD (PϽ0.01) in African American and white men but not in women. This association remained significant after adjusting for age, diabetes mellitus, smoking, hypertension, HDL cholesterol, LDL cholesterol, and triglycerides. We conclude that elevated levels of Lp(a) with small apo(a) isoforms independently predict risk for CAD in African American and white men. Our study, by determining the predictive power of Lp(a) levels combined with apo(a) isoform size, provides an explanation for the apparent lack of association of either measure alone with CAD in African Americans. Furthermore, our results suggest that small apo(a) size confers atherogenicity to Lp(a) for cardiovascular disease. [1][2][3] In numerous, but not all, prospective studies, mainly in white populations, elevations of plasma Lp(a) levels, usually defined as Ն30 mg/dL, were significantly correlated with coronary artery disease (CAD). 4 -13 Curiously, although mean Lp(a) levels are twice as high in African Americans compared with whites, studies to date have failed to establish a significant association between elevated Lp(a) levels (Ն30 mg/dL) and CAD among African Americans. 1,14 -16 The lack of understanding of this racial difference has made it difficult to conclude with full confidence that Lp(a) is a risk factor for CAD..In addition to high Lp(a) levels, the presence of small apo(a) isoforms has been associated with CAD in whites. [17][18][19][20][21][22][23][24] In the majority of studies using high-resolution sizing techniques, small apo(a) size has been defined as Ͻ22 kringle 4 (K4) repeats. 17,18,24 The majority of whites with high Lp(a) levels possesses at least 1 small apo(a) isoform; however, the majority of African Americans with high Lp(a) levels has no small apo(a) isoform. 25 The high degree of correlation between elevated levels of Lp(a) and small apo(a) isoforms in whites makes it difficult to ascerta...

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Lipoprotein Lp(a) and the risk for myocardial infarction

Cited by 664 publications

References 11 publications

Factors contributing to variation in lipoprotein (a) in Melbourne Anglo-Celtic population

Factors contributing to variation in lipoprotein (a) in Melbourne Anglo-Celtic population

The assembly of lipoprotein Lp(a)

High Levels of Lp(a) With a Small Apo(a) Isoform Are Associated With Coronary Artery Disease in African American and White Men

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