(Circulation. 1997;95:329-334.)
© 1997 American Heart Association, Inc.
Articles |
Lipoprotein(a) as a Determinant of Coronary Heart Disease in Young Women
the National Institute for Psychosocial Factors and Health and Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden (K.O.-G., S.P.W., K.B.); the Institute for Prevention of Cardiovascular Disease, Deaconess Hospital, and the Department of Epidemiology, Havard School of Public Health, Boston, Mass (M.A.M.); the Department of Cardiology (K.S.-G., M.E., L.R.) and the Department of Thoracic Radiology (B.S.), Karolinska Hospital, Stockholm, Sweden; and the Division of Cardiology, University of Texas, Houston (R.K.).
Correspondence to Professor Kristina Orth-Gomer, Department of Public Health Sciences, Division of Community Medicine, Karolinska Institute, Novum Plan 7, S-141 57 Huddinge, Sweden. E-mail Kristina.Orth-Gomer{at}phs.ki.se
Background Lipoprotein(a) [Lp(a)] appears to be a risk factor for coronary heart disease (CHD) in men. The role of Lp(a) in women, however, is less clear.
Methods and Results We examined the ability of Lp(a) to predict CHD in a population-based case-control study of women 65 years of age or younger who lived in the greater Stockholm area. Subjects were all patients hospitalized for an acute CHD event between February 1991 and February 1994. Control subjects were randomly selected from the city census and were matched to patients by age and catchment area. Lp(a) was measured 3 months after hospitalization by use of an immunoturbidometric method (Incstar) calibrated to the Northwest Lipid Research Laboratories (coefficient of variation was <9%). Of the 292 consecutive patients, 110 (37%) were hospitalized for an acute myocardial infarction, and 182 were hospitalized (63%) for angina pectoris. The mean age for both patients and control subjects was 56±7 years. Of participants, 74 patients (25%) and 84 control subjects (29%) were premenopausal. The distributions of Lp(a) were highly skewed in both patients and control subjects, with a range from 0.001 to 1.14 g/L. Age-adjusted odds ratio for CHD in the highest versus the lowest quartile of Lp(a) was 2.3 (95% confidence interval [CI], 1.4 to 3.7). After adjustment for age, smoking, education, body mass index, systolic blood pressure, total cholesterol, triglycerides, and HDL, the odds ratio was 2.9 (95% CI, 1.6 to 5.0). The odds ratios were similar when myocardial infarction and angina patients were compared with their respective control subjects. The odds ratios were 5.1 (95% CI, 1.4 to 18.4) and 2.4 (95% CI, 1.3 to 4.5) in premenopausal and postmenopausal women, respectively.
Conclusions These results suggest that Lp(a) is a determinant of CHD in both premenopausal and postmenopausal women.
Key Words: coronary disease • lipoproteins • risk factors • women
This article has been cited by other articles:
 |
|
 |
|
  L. Berglund and R. Ramakrishnan Lipoprotein(a): An Elusive Cardiovascular Risk Factor Arterioscler. Thromb. Vasc. Biol., December 1, 2004; 24(12): 2219 - 2226. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Hoffmann, B.-C. Zyriax, H. Boeing, and E. Windler A dietary pattern derived to explain biomarker variation is strongly associated with the risk of coronary artery disease Am. J. Clinical Nutrition, September 1, 2004; 80(3): 633 - 640. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. R. Holmer, C. Hengstenberg, H.-G. Kraft, B. Mayer, M. Poll, S. Kurzinger, M. Fischer, H. Lowel, G. Klein, G. A.J. Riegger, et al. Association of Polymorphisms of the Apolipoprotein(a) Gene With Lipoprotein(a) Levels and Myocardial Infarction Circulation, February 11, 2003; 107(5): 696 - 701. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Stangl, G. Baumann, and K. Stangl Coronary atherogenic risk factors in women Eur. Heart J., November 2, 2002; 23(22): 1738 - 1752. [Full Text] [PDF]
|
|
|
|
 |
|
 B. Salobir, M. Sabovic, P. Peternel, and M. Stegnar Fibrinolytic Parameters and Lipoprotein(a) in Young Women with Myocardial Infarction Angiology, March 1, 2002; 53(2): 157 - 163. [Abstract] [PDF]
|
|
|
|
 |
|
 T. S Mikkola and T. B Clarkson Estrogen replacement therapy, atherosclerosis, and vascular function Cardiovasc Res, February 15, 2002; 53(3): 605 - 619. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Weidner, C.-W. Kohlmann, M. Horsten, S. P. Wamala, K. Schenck-Gustafsson, M. Hogbom, and K. Orth-Gomer Cardiovascular Reactivity to Mental Stress in the Stockholm Female Coronary Risk Study Psychosom Med, November 1, 2001; 63(6): 917 - 924. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Rajaram, K. Burke, B. Connell, T. Myint, and J. Sabate A Monounsaturated Fatty Acid-Rich Pecan-Enriched Diet Favorably Alters the Serum Lipid Profile of Healthy Men and Women J. Nutr., September 1, 2001; 131(9): 2275 - 2279. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. P Wamala, J. Lynch, and G. A Kaplan Women's exposure to early and later life socioeconomic disadvantage and coronary heart disease risk: the Stockholm Female Coronary Risk Study Int. J. Epidemiol., April 1, 2001; 30(2): 275 - 284. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Ricci, G. Tamaro, R. Simeone, E. Giolo, G. Nucera, F. De Seta, and S. Guaschino Lipoprotein(a) changes during natural menstrual cycle and ovarian stimulation with recombinant and highly purified urinary FSH Hum. Reprod., March 1, 2001; 16(3): 449 - 456. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. E Wangen, A. M Duncan, X. Xu, and M. S Kurzer Soy isoflavones improve plasma lipids in normocholesterolemic and mildly hypercholesterolemic postmenopausal women Am. J. Clinical Nutrition, February 1, 2001; 73(2): 225 - 231. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Orth-Gomer, S. P. Wamala, M. Horsten, K. Schenck-Gustafsson, N. Schneiderman, and M. A. Mittleman Marital Stress Worsens Prognosis in Women With Coronary Heart Disease: The Stockholm Female Coronary Risk Study JAMA, December 20, 2000; 284(23): 3008 - 3014. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Paultre, T. A. Pearson, H. F. C. Weil, C. H. Tuck, M. Myerson, J. Rubin, C. K. Francis, H. F. Marx, E. F. Philbin, R. G. Reed, et al. High Levels of Lp(a) With a Small Apo(a) Isoform Are Associated With Coronary Artery Disease in African American and White Men Arterioscler. Thromb. Vasc. Biol., December 1, 2000; 20(12): 2619 - 2624. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Horsten, M.A Mittleman, S.P Wamala, K Schenck-Gustafsson, and K Orth-Gomer Depressive symptoms and lack of social integration in relation to prognosis of CHD in middle-aged women. The Stockholm Female Coronary Risk Study Eur. Heart J., July 1, 2000; 21(13): 1072 - 1080. [Abstract] [PDF]
|
|
|
|
|
|
B. E Merz-Demlow, A. M Duncan, K. E Wangen, X. Xu, T. P Carr, W. R Phipps, and M. S Kurzer Soy isoflavones improve plasma lipids in normocholesterolemic, premenopausal women Am. J. Clinical Nutrition, June 1, 2000; 71(6): 1462 - 1469. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Nishino, M. J. Malloy, J. Naya-Vigne, J. Russell, J. P. Kane, and R. F. Redberg Lack of association of lipoprotein(a) levels with coronary calcium deposits in asymptomatic postmenopausal women J. Am. Coll. Cardiol., February 1, 2000; 35(2): 314 - 320. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kagawa, H. Azuma, M. Akaike, Y. Kanagawa, and T. Matsumoto Aspirin Reduces Apolipoprotein(a) (Apo(a)) Production in Human Hepatocytes by Suppression of Apo(a) Gene Transcription J. Biol. Chem., November 26, 1999; 274(48): 34111 - 34115. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. J. Harjai Potential New Cardiovascular Risk Factors: Left Ventricular Hypertrophy, Homocysteine, Lipoprotein(a), Triglycerides, Oxidative Stress, and Fibrinogen Ann Intern Med, September 7, 1999; 131(5): 376 - 386. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. T. Raitakari, M. R. Adams, and D. S. Celermajer Effect of Lp(a) on the Early Functional and Structural Changes of Atherosclerosis Arterioscler. Thromb. Vasc. Biol., April 1, 1999; 19(4): 990 - 995. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. P. Wamala, M. A. Murray, M. Horsten, M. Eriksson, K. Schenck-Gustafsson, A. Hamsten, A. Silveira, and K. Orth-Gomer Socioeconomic Status and Determinants of Hemostatic Function in Healthy Women Arterioscler. Thromb. Vasc. Biol., March 1, 1999; 19(3): 485 - 492. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Eriksson, N. Egberg, S. Wamala, K. Orth-Gomer, M. A. Mittleman, and K. Schenck-Gustafsson Relationship Between Plasma Fibrinogen and Coronary Heart Disease in Women Arterioscler. Thromb. Vasc. Biol., January 1, 1999; 19(1): 67 - 72. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Y. Craig, L. M. Neveux, G. E. Palomaki, M. M. Cleveland, and J. E. Haddow Lipoprotein(a) as a risk factor for ischemic heart disease: metaanalysis of prospective studies Clin. Chem., November 1, 1998; 44(11): 2301 - 2306. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Ribichini, G. Steffenino, A. Dellavalle, A. Vado, V. Ferrero, T. Camilla, S. Giubergia, and E. Uslenghi Plasma Lipoprotein(a) Is Not a Predictor for Restenosis After Elective High-Pressure Coronary Stenting Circulation, September 22, 1998; 98(12): 1172 - 1177. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Su, H. Campos, H. Judge, B. W. Walsh, and F. M. Sacks Metabolism of Apo(a) and ApoB100 of Lipoprotein(a) in Women: Effect of Postmenopausal Estrogen Replacement J. Clin. Endocrinol. Metab., September 1, 1998; 83(9): 3267 - 3276. [Abstract] [Full Text]
|
|
|
|
|
|
M. A. Espeland, S. M. Marcovina, V. Miller, P. D. Wood, C. Wasilauskas, R. Sherwin, H. Schrott, and T. L. Bush Effect of Postmenopausal Hormone Therapy on Lipoprotein(a) Concentration Circulation, March 17, 1998; 97(10): 979 - 986. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A. Enas and K. Orth-Gomer Lipoprotein(a) as a Determinant of Coronary Heart Disease in Young Women: A Stronger Risk Factor Than Diabetes? • Response Circulation, January 27, 1998; 97(3): 293 - 295. [Full Text]
|
|
|
|
|
|
S. P. Fortmann and S. M. Marcovina Lipoprotein(a), a Clinically Elusive Lipoprotein Particle Circulation, January 21, 1997; 95(2): 295 - 296. [Full Text]
|
|