Is lipoprotein(a) an independent risk factor for ischemic heart disease in men?: The Quebec cardiovascular study
Is lipoprotein(a) an independent risk factor for ischemic heart disease in men?: The Quebec cardiovascular study
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DOI：
10.1016/s0735-1097(97)00528-7
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发表时间：
1998-03-01
影响因子：
24
通讯作者：
Dagenais, GR
中科院分区：
文献类型：
--
作者：
Cantin, B;Gagnon, F;Dagenais, GR
目标.本研究旨在确定脂蛋白（a）[Lp（a）]是否是缺血性心脏病（IHD）的独立危险因素，并建立Lp（a）与其他脂质组分的关系。一些但不是所有的研究表明，Lp（a）浓度升高可能与IHD有关;很少有前瞻性的。在2，156名47至76岁的法裔加拿大男性中进行了一项为期5年的前瞻性随访研究，没有IHD的临床证据。基线时获得的血脂测量值包括总胆固醇、低密度脂蛋白（LDL）胆固醇、高密度脂蛋白（HDL）胆固醇、载脂蛋白B和Lp（a）。在随访期间，有116例首次IHD事件（心肌梗死、心绞痛、死亡）。调整比例风险模型用于估计不同变量的相对风险。根据Lp（a）水平和其他脂质危险因素三分位数对队列进行分类，以评估Lp（a）水平升高与这些危险因素的关系。Lp（a）的截止值为30 mg/dl。使用低Lp（a）水平组和第一个三分位的血脂测量值作为参考计算风险比。Lp（a）不是IHD的独立危险因素，但可增加LDL胆固醇轻度升高、总胆固醇和载脂蛋白B水平升高的有害作用，并可抵消HDL胆固醇水平升高的有益作用。在该队列中，Lp（a）不是IHD的独立危险因素，但似乎增加了与其他脂质危险因素相关的风险。(C)1998年，美国心脏病学会。
Objectives. This study was undertaken to determine whether lipoprotein(a) [Lp(a)] is an independent risk factor for ischemic heart disease (IHD) and to establish the relation of Lp(a) to the other lipid fractions.Background. Several, but not all, studies have shown that elevated Lp(a) concentrations may be associated with IHD; very few have been prospective.Methods. A 5-year prospective follow-up study was conducted in 2,156 French Canadian men 47 to 76 years old, without clinical evidence of IHD. Lipid measurements obtained at baseline included total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, apoprotein B and Lp(a). During the follow-up period, there were 116 first IHD events (myocardial infarction, angina, death). Adjusted proportional hazards models were used to estimate the relative risk for the different variables. The cohort was also classified according to Lp(a) levels and other lipid risk factor tertiles to evaluate the relation of elevated Lp(a) levels to these risk factors. A cutoff value of 30 mg/dl was used for Lp(a). Risk ratios were calculated using the group with low Lp(a) levels and the first tertile of lipid measures as a reference.Results. Lp(a) was not an independent risk factor for IHD but seemed to increase the deleterious effects of mildly elevated LDL cholesterol and elevated total cholesterol and apoprotein B levels and seemed to counteract the beneficial effects associated with elevated HDL cholesterol levels.Conclusions. In this cohort, Lp(a) was not an independent risk factor for IHD but appeared to increase the risk associated with other lipid risk factors. (C) 1998 by the American College of Cardiology.