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Atherosclerosis. 2018 Feb;269:29-34. doi: 10.1016/j.atherosclerosis.2017.12.011. Epub 2017 Dec 7.

High levels of lipoprotein (a) and premature acute coronary syndrome.

Author information

1
Second Department of Cardiology, University General Hospital Attikon, Athens, Greece. Electronic address: lrallidis@gmail.com.
2
"KAT" General Hospital of Attica, Athens, Greece.
3
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
4
251 Air Force General Hospital, Athens, Greece.
5
Second Department of Cardiology, University General Hospital Attikon, Athens, Greece.
6
Biochemistry Laboratory, General Hospital of Nikea, Piraeus, Greece.
7
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Faculty of Health, University of Canberra, Australia; School of Allied Health, College of Science, Health and Engineering, LA TROBE University, Australia.

Abstract

BACKGROUND AND AIMS:

High levels of lipoprotein(a) [Lp(a)] are associated with increased risk of acute coronary syndrome (ACS). We explored whether Lp(a) exhibits a stronger association with premature ACS.

METHODS:

A case-control study was conducted; 1457 patients with a history of ACS (54.8 ± 13 years, 86% males) and 2090 age-sex matched adults free of cardiovascular disease were enrolled. Bio-clinical characteristics [risk factors, low-density lipoprotein-cholesterol, Lp(a)] were derived through standard procedures.

RESULTS:

A 10 mg/dL increase in Lp(a) was associated with 4% (95% CI, 1.01 to 1.02) higher likelihood of having ACS in younger (<45 years) and 2% (95% CI, 1.01 to 1.02) higher likelihood in middle-aged (45-60 years) individuals. Adjusting for common risk factors, elevated Lp(a), i.e. >50 mg/dL, was still associated with increased likelihood of ACS in younger adults (<45 years) (OR = 2.88, 95% CI, 1.7 to 4.6) and in middle aged ones (45 and 60 years) (OR = 2.06, 95% CI, 1.4 to 3.2), but not in older participants (>60 years) (OR = 1.31, 95% CI, 0.8 to 2.4).

CONCLUSIONS:

Lp(a) seems to be an independent risk factor for ACS in individuals <45 years, and high Lp(a) levels increase by ∼3folds the risk for ACS. The association is preserved but is less in middle-aged individuals (45-60 years) and is abolished >60 years.

KEYWORDS:

Acute coronary syndrome; Lipoprotein(a); Premature myocardial infarction

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