Lipoprotein(a) Is an Independent Risk Factor for Cardiovascular Disease in Heterozygous Familial Hypercholesterolemia
- 1 November 2005
- journal article
- Published by Oxford University Press (OUP) in Clinical Chemistry
- Vol. 51 (11), 2067-2073
- https://doi.org/10.1373/clinchem.2005.055228
Abstract
Background: The role of lipoprotein(a) [Lp(a)] as a predictor of cardiovascular disease (CVD) in patients with heterozygous familial hypercholesterolemia (HFH) is unclear. We sought to examine the utility of this lipoprotein as a predictor of CVD outcomes in the HFH population at our lipid clinic. Methods: This was a retrospective analysis of clinical and laboratory data from a large multiethnic cohort of HFH patients at a single, large lipid clinic in Vancouver, Canada. Three hundred and eighty-eight patients were diagnosed with possible, probable, or definite HFH by strict clinical diagnostic criteria. Multivariate Cox regression analysis was used to study the relationship between several established CVD risk factors, Lp(a), and the age of first hard CVD event. Results: An Lp(a) concentration of 800 units/L (560 mg/L) or higher was a significant independent risk factor for CVD outcomes [hazard ratio (HR) = 2.59; 95% confidence interval (CI), 1.53–4.39; P <0.001]. Other significant risk factors were male sex [HR = 3.19 (1.79–5.69); P <0.001] and ratio of total to HDL-cholesterol [1.18 (1.07–1.30); P = 0.001]. A previous history of smoking or hypertension each produced HRs consistent with increased CVD risk [HR = 1.55 (0.92–2.61) and 1.57 (0.90–2.74), respectively], but neither reached statistical significance (both P = 0.10). LDL-cholesterol was not an independent predictor of CVD risk [HR = 0.85 (0.0.71–1.01); P = 0.07], nor was survival affected by the subcategory of HFH diagnosis (i.e., possible vs probable vs definite HFH). Conclusion: Lp(a) is an independent predictor of CVD risk in a multiethnic HFH population.Keywords
Funding Information
- Pfizer
This publication has 23 references indexed in Scilit:
- Established and emerging coronary risk factors in patients with heterozygous familial hypercholesterolaemiaHeart, 2004
- Apolipoprotein E genotype is not associated with cardiovascular disease in heterozygous subjects with familial hypercholesterolemiaAmerican Heart Journal, 2003
- Importance of HDL cholesterol levels and the total/ HDL cholesterol ratio as a risk factor for coronary heart disease in molecularly defined heterozygous familial hypercholesterolaemiaEuropean Heart Journal, 2001
- Estrogen and Progestin Compared with Simvastatin for Hypercholesterolemia in Postmenopausal WomenThe New England Journal of Medicine, 1997
- Familial defective apolipoprotein B-100 is clinically indistinguishable from familial hypercholesterolemiaArchives of Internal Medicine, 1993
- Relation of lipoprotein(a) to coronary heart disease and duplexsonographic findings of the carotid arteries in heterozygous familial hypercholesterolemiaAtherosclerosis, 1993
- Serum lipoprotein(a) in patients heterozygous for familial hypercholesterolemia, their relatives, and unrelated control populations.Arteriosclerosis and Thrombosis: A Journal of Vascular Biology, 1991
- Apolipoprotein(a) and ischaemic heart disease in familial hypercholesterolaemiaThe Lancet, 1990
- Relation of Serum Lipoprotein(a) Concentration and Apolipoprotein(a) Phenotype to Coronary Heart Disease in Patients with Familial HypercholesterolemiaThe New England Journal of Medicine, 1990
- LIPOPROTEIN (a) AND CORONARY HEART DISEASE IN FAMILIAL HYPERCHOLESTEROLAEMIAThe Lancet, 1988