This study sought to demonstrate the impact of elevated serum lipoprotein a [Lp(a)] concentrations on the risk of coronary heart disease (CHD) in patients with type 2 diabetes. For that purpose, 352 patients (237 men and 116 women, 33-85 years of age) with type 2 diabetes were examined. The overall prevalence of CHD in the study subjects was 7.8% (25/352). Patients with a history of CHD had significantly higher serum concentrations of Lp(a) than those without a history of CHD, and those elevated concentrations were a significant risk factor for CHD. Moreover, serum concentrations of Lp(a) greater than 50 mg/dL were associated with a 3.3 fold increase in the risk of CHD, representing an apparent threshold for an increase in CHD risk in patients with type 2 diabetes. Elevated serum Lp(a) was singled out as a significant CHD risk factor, and the risk of CHD appeared to increase with increasing serum Lp(a) concentrations.
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