Lipoprotein (a) and coronary heart disease among women: Beyond a cholesterol carrier?

Aims: With its homology with plasminogen, lipoprotein(a) [Lp(a)] may be related to thrombosis and inflammation. We assessed the role of Lp(a) in coronary heart diseases (CHD) by a recently developed assay that is not affected by the plasminogen-like Kringle-type- 2 repeats. Methods and results: Of 32 826 women from the Nurses' Health Study, who provided blood at baseline, we documented 228 CHD events during 8 years of follow-up. Each case was compared with two matched controls. In a multivariable model adjusted for body mass index, family history, hypertension, diabetes, post-menopausal hormone use, physical activity, blood drawing characteristics, and alcohol intake, the odd ratio (OR) for Lp(a) levels ≥30 mg/dL was 1.9(95% Cl: 1.3-3.0) when compared with those with Lp(a) <30 mg/dL. Women with high levels of both Lp(a) (≥30 mg/dL) and fibrinogen (≥400 mg/dL) had an OR of 3.2(95% Cl: 1.6-6.5) for CHD, when compared with the combination of low levels (P interaction = 0.05). Women with high levels of both Lp(a) and C-reactive protein (≥3 mg/L) had an OR of 3.67(95% Cl: 2.03-6.64) for CHD, when compared with the combination of low levels (P interaction = 0.06). Conclusion: Lp(a) levels >30 mg/dL are associated with twice the risk of CHD events among women and may be related to thrombosis and inflammation.