Associations Between Lipoprotein(a) Levels and Cardiovascular Outcomes in African Americans and Caucasians: The Atherosclerosis Risk in Communities (ARIC) Study
By Salim S. Virani, Ariel Brautbar, Brian C Davis, Vijay Nambi, R. Hoogeveen, A. Richey Sharrett, Josef Coresh, Thomas H. Mosley, J. Morrisett, Diane J. Catellier and 5 more. Circulation, 2011
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Background— On the basis of studies with limited statistical power, lipoprotein(a) [Lp(a)] is not considered a risk factor for cardiovascular disease (CVD) in blacks. We evaluated associations between Lp(a) and incident CVD events in blacks and whites in the Atherosclerosis Risk in Communities (ARIC) study. Methods and Results— Plasma Lp(a) was measured in blacks (n=3467) and whites (n=9851). Hazards ratios (HRs) for incident CVD events (coronary heart disease and ischemic strokes) were calculated. Lp(a) levels were higher with wider interindividual variation in blacks (median [interquartile range], 12.8 [7.1–21.7] mg/dL) than whites (4.3 [1.7–9.5] mg/dL; P<0.0001). At 20 years of follow-up, 676 CVD events occurred in blacks, and 1821 events occurred in whites. Adjusted HRs (95% confidence interval) per race-specific 1-SD–greater log-transformed Lp(a) were 1.13 (1.04–1.23) for incident CVD, 1.11 (1.00–1.22) for incident coronary heart disease, and 1.21 (1.06–1.39) for ischemic strokes in blacks. For whites, the respective HRs (95% confidence intervals) were 1.09 (1.04–1.15), 1.10 (1.05–1.16), and 1.07 (0.97–1.19). Quintile analyses showed that risk for incident CVD was graded but statistically significant only for the highest compared with the lowest quintile (HR [95% confidence interval], 1.35 [1.06–1.74] for blacks and 1.27 [1.10–1.47] for whites). Similar results were obtained with the use of Lp(a) cutoffs of ⩽10 mg/dL, >10 to ⩽20 mg/dL, >20 to ⩽30 mg/dL, and >30 mg/dL. Conclusions— Lp(a) levels were positively associated with CVD events. Associations were at least as strong, with a larger range of Lp(a) concentrations, in blacks compared with whites.
Subfields: Emergency Medicine, Immunology, Surgery
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Citations in the corpus
- National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2. (2015, result): “Newer data from ARIC indicate that Lp(a) levels were positively associated with CVD events, at least as strongly and with a larger range of Lp(a) concentrations, in AAs compared with whites.(524) This contradicts the previously suggested paradox for Lp(a) in AAs.”
- Metabolism pathways of arachidonic acids: mechanisms and potential therapeutic targets (2021, background): “CYP-derived EETs, atherosclerosis, and coronary artery disease: Polymorphisms in the CYP2J2 gene have been shown to affect CAD risk and incidence in specific populations.(195,196) One of the most relevant polymorphisms in terms of frequency and functional importance is located at −50 (G-50T) in the ”
- Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation (2017, background): “Hypertension, stroke and cardiovascular diseases are also increased in obesity (82).”