1–16 However, the use of lipoprotein(a) as a risk factor for MI and IHD has not been implemented in clinical practice. 1 Previous in vitro, animal, and epidemiological studies suggest that lipoprotein(a) could contribute to the development of atherosclerosis and/or thrombosis and thus myocardial infarction (MI) and ischemic heart disease (IHD). Lipoprotein(a) is composed of a low-density lipoprotein (LDL) particle bound to a plasminogen-like glycoprotein named apolipoprotein(a). Extreme lipoprotein(a) levels predict a 3- to 4-fold increase in risk of MI in the general population and absolute 10-year risks of 20% and 35% in high-risk women and men. Equivalent values in men were 19% and 35%.Ĭonclusions- We observed a stepwise increase in risk of MI with increasing levels of lipoprotein(a), with no evidence of a threshold effect. In women, multifactorially adjusted hazard ratios for MI for elevated lipoprotein(a) levels were 1.1 (95% CI, 0.6 to 1.9) for 5 to 29 mg/dL (22nd to 66th percentile), 1.7 (1.0 to 3.1) for 30 to 84 mg/dL (67th to 89th percentile), 2.6 (1.2 to 5.9) for 85 to 119 mg/dL (90th to 95th percentile), and 3.6 (1.7 to 7.7) for ≥120 mg/dL (>95th percentile) versus levels 60 years with lipoprotein(a) levels of <5 and ≥120 mg/dL, respectively. During 10 years of follow-up, 498 participants developed MI. Methods and Results- We examined 9330 men and women from the general population in the Copenhagen City Heart Study. We tested the hypothesis that extreme lipoprotein(a) levels predict MI in the general population, measuring levels shortly after sampling, correcting for regression dilution bias, and calculating hazard ratios and absolute risk estimates.

Limitations of previous studies include lack of risk estimates for extreme lipoprotein(a) levels, measurements in long-term frozen samples, no correction for regression dilution bias, and lack of absolute risk estimates in the general population. Customer Service and Ordering Informationīackground- Elevated lipoprotein(a) levels are associated with myocardial infarction (MI) in some but not all studies.

Journal of the American Heart Association (JAHA).

Stroke: Vascular and Interventional Neurology.

Circ: Cardiovascular Quality & Outcomes.

Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).

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