Several prospective studies have shown that plasma levels of lipoprotein(a) [Lp(a)] are associated with coronary heart disease (CHD) risk. In this analysis conducted in the Reykjavik prospective study, Bennet et al. investigated the risk associated with Lp(a) in 2,047 patients who were free from CHD at baseline and eventually developed CHD. They were compared to 3,921 controls from the same study sample. After adjusting for traditional risk factors such as age, sex, smoking status, blood pressure, total cholesterol levels, triglyceride concentrations, diabetes, and body mass index, the odds ratio for future CHD associated with having Lp(a) levels in the top tertile was 1.60 (95% CI, 1.38-1.85). The authors highlighted the fact that the risk associated with elevated Lp(a) concentrations was comparable to that for either increased C-reactive protein (CRP) or triglyceride levels. However, in multivariate models, Lp(a) kept its predictive value, while other markers such as CRP and triglycerides did not. The paper also reviewed the odds ratio for future CHD associated with Lp(a) in 31 other prospective studies.
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