Lipoprotein(a) Level Linked to Risk of Coronary Events – (03-15-01)

Lipoprotein(a) Level Linked to Risk of Coronary Events

We’ve talked about “nontraditional” risk factors for cardiovascular disease such as homocysteine, CRP, fibrinogen and lipoprotein a. This study closely examined the role that lipoprotein a plays in relation to heart disease and found that the risk of high levels is greater when other cardiovascular risk factors are also present, such as low HDL, high LDL and hypertension. Could we envision a better way to express the importance of a global approach to heart disease? The one-cause-one-cure idea can be thrown out the window when it comes to chronic diseases such as heart disease, arthritis, diabetes, osteoporosis and cancer.

J Am Coll Cardiol 2001;37:434-439 Perhaps ending a longstanding controversy, a new population-based study connects elevated levels of lipoprotein(a) with increased coronary risk in middle-aged men, especially those with high LDL cholesterol levels, low HDL cholesterol levels, hypertension and/or other risk factors. Dr. Arnold von Eckardstein, from the Westfalische Wilhelms-Universitat Munster, Germany, and colleagues collected data on 788 men, 35 to 65 years of age, who participated in the Prospective Cardiovascular Munster study. Over 10 years of follow-up, the researchers evaluated levels of lipoprotein(a) as well as traditional cardiovascular risk factors. During that period, 44 men experienced myocardial infarctions, while the remaining 744 subjects survived without a major coronary event or stroke, according to the research team’s report in the Journal of the American College of Cardiology for February. Dr. von Eckardstein’s group found a 2.7 times increased risk for coronary events among men whose lipoprotein(a) levels were 0.2 g/L or more, compared with subjects with lower levels. The risk was especially prominent in men with LDL cholesterol levels of 4.1 mmol/L or more (relative risk 2.6), and men with HDL cholesterol of 0.9 mmol/L or less (relative risk 8.3). The risk was also strongly associated with hypertension (relative risk 3.2). “Because lipoprotein(a) increases the risk of coronary events strongly depending on the presence of additional coronary risk factors, it is imperative to strictly control additional risk factors in individuals with elevated lipoprotein(a),” Dr. von Eckardstein and colleagues conclude.