Cardiovascular disease risk associated with elevated lipoprotein(a) attenuates at low low-density lipoprotein cholesterol levels in a primary prevention setting.
Cardiovascular disease risk associated with elevated lipoprotein(a) attenuates at low low-density lipoprotein cholesterol levels in a primary prevention setting.
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DOI：
10.1093/eurheartj/ehy334
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发表时间：
2018-07-14
影响因子：
39.3
通讯作者：
Stroes ESG
中科院分区：
文献类型：
--
作者：
Verbeek R;Hoogeveen RM;Langsted A;Stiekema LCA;Verweij SL;Hovingh GK;Wareham NJ;Khaw KT;Boekholdt SM;Nordestgaard BG;Stroes ESG
脂蛋白(a) [Lp(a)]升高是心血管疾病（CVD）的一个因果危险因素。然而，有研究表明，Lp(a)升高主要在低密度脂蛋白胆固醇（LDL-C）水平较高的个体中引起CVD。我们假设在低LDL-C水平下，与高Lp(a)水平相关的风险将在很大程度上减弱。对来自EPIC-Norfolk前瞻性人口研究的16,654名个体和来自哥本哈根城市心脏研究（CCHS）的9,448名个体进行平行统计分析。根据个体的Lp(a)和LDL-C水平进行分类。Lp(a)的截断值设为第80个队列百分位数。LDL-C临界值分别为2.5、3.5、4.5和5.5 mmol/L。初步分析中的LDL-C水平被校正为Lp(a)衍生的LDL-C （LDL-Ccorr）。计算每个类别的多变量校正风险比（HR）。以LDL-Ccorr <2.5 mmol/L和Lp(a) <第80个队列百分位为参考类别。在EPIC-Norfolk和CCHS队列中，对于任何LDL-Ccorr水平≥2.5 mmol/L, Lp(a)≥80百分位数的个体与Lp(a) <80百分位数的个体相比，CVD风险增加。相反，当LDL-Ccorr <2.5 mmol/L时，与Lp(a)升高相关的风险减弱。然而，在两个队列中，LDL-Ccorr和Lp(a)水平与CVD风险之间没有相互作用。Lp(a)和LDL-C与CVD风险独立相关。当LDL-C水平低于2.5 mmol/L时，在一级预防设置中与Lp(a)升高相关的风险减弱。
Lipoprotein(a) [Lp(a)] elevation is a causal risk factor for cardiovascular disease (CVD). It has however been suggested that elevated Lp(a) causes CVD mainly in individuals with high low-density lipoprotein cholesterol (LDL-C) levels. We hypothesized that the risk associated with high Lp(a) levels would largely be attenuated at low LDL-C levels. In 16,654 individuals from the EPIC-Norfolk prospective population study and in 9,448 individuals from the Copenhagen City Heart Study (CCHS) parallel statistical analyses were performed. Individuals were categorized according to their Lp(a) and LDL-C levels. Cut-offs were set at the 80th cohort percentile for Lp(a). LDL-C cut-offs were set at 2.5, 3.5, 4.5 and 5.5 mmol/L. LDL-C levels in the primary analyses were corrected for Lp(a)-derived LDL-C (LDL-Ccorr). Multivariable-adjusted hazard ratios (HR) were calculated for each category. The category with LDL-Ccorr <2.5 mmol/L and Lp(a) <80th cohort percentile was used as reference category. In the EPIC-Norfolk and CCHS cohorts, individuals with an Lp(a) ≥80th percentile were at increased CVD risk compared to those with Lp(a) <80th percentile for any LDL-Ccorr levels ≥2.5 mmol/L. In contrast, for LDL-Ccorr <2.5 mmol/L, the risk associated with elevated Lp(a) attenuated. However, there was no interaction between LDL-Ccorr and Lp(a) levels on CVD risk in either cohort. Lp(a) and LDL-C are independently associated with CVD risk. At LDL-C levels below <2.5 mmol/L, the risk associated with elevated Lp(a) attenuates in a primary prevention setting.
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影响因子：
37.8
作者：
Khera AV;Everett BM;Caulfield MP;Hantash FM;Wohlgemuth J;Ridker PM;Mora S
通讯作者：
Mora S
影响因子：
120.7
作者：
Erqou, Sebhat;Kaptoge, Stephen;Perry, Philip L.;Di Angelantonio, Emanuele;Thompson, Alexander;White, Ian R.;Marcovina, Santica M.;Collins, Rory;Thompson, Simon G.;Danesh, John
通讯作者：
Danesh, John
影响因子：
6.2
作者：
Anderson, Todd J.;Gregoire, Jean;Ward, Richard
通讯作者：
Ward, Richard
影响因子：
39.3
作者：
Nordestgaard BG;Chapman MJ;Ray K;Borén J;Andreotti F;Watts GF;Ginsberg H;Amarenco P;Catapano A;Descamps OS;Fisher E;Kovanen PT;Kuivenhoven JA;Lesnik P;Masana L;Reiner Z;Taskinen MR;Tokgözoglu L;Tybjærg-Hansen A;European Atherosclerosis Society Consensus Panel
通讯作者：
European Atherosclerosis Society Consensus Panel
影响因子：
37.8
作者：
Kamstrup, Pia R.;Benn, Marianne;Nordestgaard, Borge G.
通讯作者：
Nordestgaard, Borge G.