Lipoprotein(a) and Risk of Coronary, Cerebrovascular, and Peripheral Artery Disease

Author:

Gurdasani Deepti1,Sjouke Barbara1,Tsimikas Sotirios1,Hovingh G. Kees1,Luben Robert N.1,Wainwright Nicholas W. J.1,Pomilla Cristina1,Wareham Nicholas J.1,Khaw Kay-Tee1,Boekholdt S. Matthijs1,Sandhu Manjinder S.1

Affiliation:

1. From the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom (D.G., M.S.S., N.W.J.W., C.P., R.N.L., K.T.K.); Genetic Epidemiology Group, Wellcome Trust Sanger Institute, Hinxton, United Kingdom (D.G., M.S.S., C.P.); Departments of Vascular Medicine (B.S., G.K.H.) and Cardiology (S.M.B.), Academic Medical Center, Amsterdam, The Netherlands; Vascular Medicine Program, University of California San Diego, La Jolla, CA (S.T.); and...

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. Conclusion— 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.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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