Lipoprotein(a) and Risk of Coronary, Cerebrovascular, and Peripheral Artery Disease The EPIC-Norfolk Prospective Population Study

Deepti Gurdasani, Barbara Sjouke, Sotirios Tsimikas, G. Kees Hovingh, Robert N. Luben, Nicholas W. J. Wainwright, Cristina Pomilla, Nicholas J. Wareham, Kay-Tee Khaw, S. Matthijs Boekholdt, Manjinder S. Sandhu

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Abstract

Objective-Although the association between circulating levels of lipoprotein(a) [Lp(a)] and risk of coronary artery disease (CAD) and stroke is well established, its role in risk of peripheral arterial disease (PAD) remains unclear. Here, we examine the association between Lp(a) levels and PAD in a large prospective cohort. To contextualize these findings, we also examined the association between Lp(a) levels and risk of stroke and CAD and studied the role of low-density lipoprotein as an effect modifier of Lp(a)-associated cardiovascular risk. Methods and Results-Lp(a) levels were measured in apparently healthy participants in the European Prospective Investigation of Cancer (EPIC)-Norfolk cohort. Cox regression was used to quantify the association between Lp(a) levels and risk of PAD, stroke, and CAD outcomes. During 212 981 person-years at risk, a total of 2365 CAD, 284 ischemic stroke, and 596 PAD events occurred in 18 720 participants. Lp(a) was associated with PAD and CAD outcomes but not with ischemic stroke (hazard ratio per 2.7-fold increase in Lp(a) of 1.37, 95% CI 1.25-1.50, 1.13, 95% CI 1.04-1.22 and 0.91, 95% CI 0.79-1.03, respectively). Low-density lipoprotein cholesterol levels did not modify these associations. Conclusion-Lp(a) levels were associated with future PAD and CAD events. The association between Lp(a) and cardiovascular disease was not modified by low-density lipoprotein cholesterol levels. (Arterioscler Thromb Vasc Biol. 2012;32:3058-3065.)
Original languageEnglish
Pages (from-to)3058-3065
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume32
Issue number12
DOIs
Publication statusPublished - 2012

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