Lipoprotein (a) as a predictor of myocardial infarction in middle-aged men
Purpose: Whether serum lipoprotein (a) [Lp(a)] levels are an independent risk factor for coronary heart disease has been controversial. We have investigated its status in a prospective population survey, the Second Northwick Park Heart Study. Methods: We recruited 2,616 men 50 to 61 years old from n...
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| Veröffentlicht in: | The American journal of medicine 2001, Vol.110 (1), p.22-27 |
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| creator | Seed, Mary Ayres, Karen L Humphries, Steve E Miller, George J |
| description | Purpose: Whether serum lipoprotein (a) [Lp(a)] levels are an independent risk factor for coronary heart disease has been controversial. We have investigated its status in a prospective population survey, the Second Northwick Park Heart Study.
Methods: We recruited 2,616 men 50 to 61 years old from nine primary care practices in the United Kingdom. Baseline serum Lp(a) levels were measured by enzyme-linked immunosorbent assay (ELISA) and were analyzed in 3 groups (75th percentile) to overcome the problem of some measurements falling below the threshold of the assay. Coronary end points included sudden cardiac death, acute myocardial infarction, silent myocardial infarction on the electrocardiogram, and coronary artery bypass surgery.
Results: During a mean of 6 years of follow-up, 121 men had coronary events. In a multivariate analysis that also adjusted for fibrinogen, Apo-A1, Apo-B, and triglyceride levels, we identified several independent risk factors for coronary events, including cholesterol level (hazard ratio [HR] = 1.5 per SD 95% confidence interval [CI] 1.3 to 1.8), diabetes (HR = 4.1, 95% CI: 2.0 to 8.4), current versus never smoking (HR = 2.5, 95% CI: 1.5 to 4.1), diastolic blood pressure (HR = 1.4 per SD, 95% CI: 1.1 to 1.7), Apo-A1 (HR = 0.8 per SD, 95% CI: 0.6 to 0.9), age (HR = 1.3 per SD, 95% CI: 1.1 to 1.6), and Lp(a) (>26.3 mg/dL [75th percentile] versus |
| doi_str_mv | 10.1016/S0002-9343(00)00652-5 |
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Methods: We recruited 2,616 men 50 to 61 years old from nine primary care practices in the United Kingdom. Baseline serum Lp(a) levels were measured by enzyme-linked immunosorbent assay (ELISA) and were analyzed in 3 groups (<25th percentile, 25th to 75th percentile, and >75th percentile) to overcome the problem of some measurements falling below the threshold of the assay. Coronary end points included sudden cardiac death, acute myocardial infarction, silent myocardial infarction on the electrocardiogram, and coronary artery bypass surgery.
Results: During a mean of 6 years of follow-up, 121 men had coronary events. In a multivariate analysis that also adjusted for fibrinogen, Apo-A1, Apo-B, and triglyceride levels, we identified several independent risk factors for coronary events, including cholesterol level (hazard ratio [HR] = 1.5 per SD 95% confidence interval [CI] 1.3 to 1.8), diabetes (HR = 4.1, 95% CI: 2.0 to 8.4), current versus never smoking (HR = 2.5, 95% CI: 1.5 to 4.1), diastolic blood pressure (HR = 1.4 per SD, 95% CI: 1.1 to 1.7), Apo-A1 (HR = 0.8 per SD, 95% CI: 0.6 to 0.9), age (HR = 1.3 per SD, 95% CI: 1.1 to 1.6), and Lp(a) (>26.3 mg/dL [75th percentile] versus <2.9 mg/dL [25th percentile], HR = 1.9, 95% CI: 1.1 to 3.3]. There was a statistically significant (
P = 0.01) difference in risk between the three levels of Lp(a).
Conclusions: We found that a high Lp(a) level was an independent predictor of the development of coronary heart disease in middle-aged men.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/S0002-9343(00)00652-5</identifier><identifier>PMID: 11152861</identifier><identifier>CODEN: AJMEAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Apolipoprotein A-I - blood ; Apolipoproteins B - blood ; Biological and medical sciences ; Cardiology. Vascular system ; Coronary Artery Bypass ; Coronary heart disease ; Death, Sudden, Cardiac ; Enzyme-Linked Immunosorbent Assay ; Health risk assessment ; Heart ; Heart attacks ; Humans ; Lipoprotein(a) - blood ; Male ; Medical sciences ; Men ; Middle age ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction - blood ; Myocardial Infarction - mortality ; Odds Ratio ; Predictive Value of Tests ; Prospective Studies ; Proteins ; Risk Factors ; Survival Analysis ; United Kingdom</subject><ispartof>The American journal of medicine, 2001, Vol.110 (1), p.22-27</ispartof><rights>2001 Excerpta Medica Inc.</rights><rights>2001 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Jan 2001</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c370t-a4938a55e8255de46b16c30277bac5b5986e09b2b9766491f150589c9ae2cba43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0002-9343(00)00652-5$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,4024,27923,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=850596$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11152861$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Seed, Mary</creatorcontrib><creatorcontrib>Ayres, Karen L</creatorcontrib><creatorcontrib>Humphries, Steve E</creatorcontrib><creatorcontrib>Miller, George J</creatorcontrib><title>Lipoprotein (a) as a predictor of myocardial infarction in middle-aged men</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>Purpose: Whether serum lipoprotein (a) [Lp(a)] levels are an independent risk factor for coronary heart disease has been controversial. We have investigated its status in a prospective population survey, the Second Northwick Park Heart Study.
Methods: We recruited 2,616 men 50 to 61 years old from nine primary care practices in the United Kingdom. Baseline serum Lp(a) levels were measured by enzyme-linked immunosorbent assay (ELISA) and were analyzed in 3 groups (<25th percentile, 25th to 75th percentile, and >75th percentile) to overcome the problem of some measurements falling below the threshold of the assay. Coronary end points included sudden cardiac death, acute myocardial infarction, silent myocardial infarction on the electrocardiogram, and coronary artery bypass surgery.
Results: During a mean of 6 years of follow-up, 121 men had coronary events. In a multivariate analysis that also adjusted for fibrinogen, Apo-A1, Apo-B, and triglyceride levels, we identified several independent risk factors for coronary events, including cholesterol level (hazard ratio [HR] = 1.5 per SD 95% confidence interval [CI] 1.3 to 1.8), diabetes (HR = 4.1, 95% CI: 2.0 to 8.4), current versus never smoking (HR = 2.5, 95% CI: 1.5 to 4.1), diastolic blood pressure (HR = 1.4 per SD, 95% CI: 1.1 to 1.7), Apo-A1 (HR = 0.8 per SD, 95% CI: 0.6 to 0.9), age (HR = 1.3 per SD, 95% CI: 1.1 to 1.6), and Lp(a) (>26.3 mg/dL [75th percentile] versus <2.9 mg/dL [25th percentile], HR = 1.9, 95% CI: 1.1 to 3.3]. There was a statistically significant (
P = 0.01) difference in risk between the three levels of Lp(a).
Conclusions: We found that a high Lp(a) level was an independent predictor of the development of coronary heart disease in middle-aged men.</description><subject>Apolipoprotein A-I - blood</subject><subject>Apolipoproteins B - blood</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Coronary Artery Bypass</subject><subject>Coronary heart disease</subject><subject>Death, Sudden, Cardiac</subject><subject>Enzyme-Linked Immunosorbent Assay</subject><subject>Health risk assessment</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Lipoprotein(a) - blood</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Men</subject><subject>Middle age</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Myocardial Infarction - blood</subject><subject>Myocardial Infarction - mortality</subject><subject>Odds Ratio</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Proteins</subject><subject>Risk Factors</subject><subject>Survival Analysis</subject><subject>United Kingdom</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0cFqFTEUBuAgFntbfQQlKEi7GD1JJslkJVKqtlxwoa7DmcwZSZmZXJO5Qt--aXvtwlUS-Dj8OT9jrwV8ECDMxx8AIBunWnUGcA5gtGz0M7YRWuvGCiOfs80TOWYnpdzUJzhtXrBjIYSWnREbdr2Nu7TLaaW48DM851g48l2mIYY1ZZ5GPt-mgHmIOPG4jJjDGtNSr3yOwzBRg79p4DMtL9nRiFOhV4fzlP36cvnz4luz_f716uLztgnKwtpg61SHWlMntR6oNb0wQYG0tsege-06Q-B62TtrTOvEKDTozgWHJEOPrTpl7x_n1th_9lRWP8cSaJpwobQv3oK2Rgpb4dv_4E3a56Vm81JJpawTrqI3B7TvZxr8LscZ863_t6IK3h0AloDTmHEJsTy5rqZzpqpPj4rqz_9Gyr6ESEuoe8wUVj-k6AX4--r8Q3X-vhcP4B-q81rdAZTMh0E</recordid><startdate>2001</startdate><enddate>2001</enddate><creator>Seed, Mary</creator><creator>Ayres, Karen L</creator><creator>Humphries, Steve E</creator><creator>Miller, George J</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Sequoia S.A</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>2001</creationdate><title>Lipoprotein (a) as a predictor of myocardial infarction in middle-aged men</title><author>Seed, Mary ; Ayres, Karen L ; Humphries, Steve E ; Miller, George J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c370t-a4938a55e8255de46b16c30277bac5b5986e09b2b9766491f150589c9ae2cba43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Apolipoprotein A-I - blood</topic><topic>Apolipoproteins B - blood</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Coronary Artery Bypass</topic><topic>Coronary heart disease</topic><topic>Death, Sudden, Cardiac</topic><topic>Enzyme-Linked Immunosorbent Assay</topic><topic>Health risk assessment</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Lipoprotein(a) - blood</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Men</topic><topic>Middle age</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Myocardial Infarction - blood</topic><topic>Myocardial Infarction - mortality</topic><topic>Odds Ratio</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Proteins</topic><topic>Risk Factors</topic><topic>Survival Analysis</topic><topic>United Kingdom</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Seed, Mary</creatorcontrib><creatorcontrib>Ayres, Karen L</creatorcontrib><creatorcontrib>Humphries, Steve E</creatorcontrib><creatorcontrib>Miller, George J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Seed, Mary</au><au>Ayres, Karen L</au><au>Humphries, Steve E</au><au>Miller, George J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lipoprotein (a) as a predictor of myocardial infarction in middle-aged men</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>2001</date><risdate>2001</risdate><volume>110</volume><issue>1</issue><spage>22</spage><epage>27</epage><pages>22-27</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>Purpose: Whether serum lipoprotein (a) [Lp(a)] levels are an independent risk factor for coronary heart disease has been controversial. We have investigated its status in a prospective population survey, the Second Northwick Park Heart Study.
Methods: We recruited 2,616 men 50 to 61 years old from nine primary care practices in the United Kingdom. Baseline serum Lp(a) levels were measured by enzyme-linked immunosorbent assay (ELISA) and were analyzed in 3 groups (<25th percentile, 25th to 75th percentile, and >75th percentile) to overcome the problem of some measurements falling below the threshold of the assay. Coronary end points included sudden cardiac death, acute myocardial infarction, silent myocardial infarction on the electrocardiogram, and coronary artery bypass surgery.
Results: During a mean of 6 years of follow-up, 121 men had coronary events. In a multivariate analysis that also adjusted for fibrinogen, Apo-A1, Apo-B, and triglyceride levels, we identified several independent risk factors for coronary events, including cholesterol level (hazard ratio [HR] = 1.5 per SD 95% confidence interval [CI] 1.3 to 1.8), diabetes (HR = 4.1, 95% CI: 2.0 to 8.4), current versus never smoking (HR = 2.5, 95% CI: 1.5 to 4.1), diastolic blood pressure (HR = 1.4 per SD, 95% CI: 1.1 to 1.7), Apo-A1 (HR = 0.8 per SD, 95% CI: 0.6 to 0.9), age (HR = 1.3 per SD, 95% CI: 1.1 to 1.6), and Lp(a) (>26.3 mg/dL [75th percentile] versus <2.9 mg/dL [25th percentile], HR = 1.9, 95% CI: 1.1 to 3.3]. There was a statistically significant (
P = 0.01) difference in risk between the three levels of Lp(a).
Conclusions: We found that a high Lp(a) level was an independent predictor of the development of coronary heart disease in middle-aged men.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11152861</pmid><doi>10.1016/S0002-9343(00)00652-5</doi><tpages>6</tpages></addata></record> |
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| subjects | Apolipoprotein A-I - blood Apolipoproteins B - blood Biological and medical sciences Cardiology. Vascular system Coronary Artery Bypass Coronary heart disease Death, Sudden, Cardiac Enzyme-Linked Immunosorbent Assay Health risk assessment Heart Heart attacks Humans Lipoprotein(a) - blood Male Medical sciences Men Middle age Middle Aged Multivariate Analysis Myocardial Infarction - blood Myocardial Infarction - mortality Odds Ratio Predictive Value of Tests Prospective Studies Proteins Risk Factors Survival Analysis United Kingdom |
| title | Lipoprotein (a) as a predictor of myocardial infarction in middle-aged men |
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