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• W2095396265 abstract "Abstract Objectives Observational and genetic studies have shown that lipoprotein(a) [ L p(a)] levels and apolipoprotein(a) [apo(a)] isoform size are both associated with coronary heart disease ( CHD ) risk, but the relative independence of these risk factors remains unclear. Clarification of this uncertainty is relevant to the potential of future L p(a)‐lowering therapies for the prevention of CHD . Methods Plasma L p(a) levels and apo(a) isoform size, estimated by the number of kringle IV ( KIV ) repeats, were measured in 995 patients with CHD and 998 control subjects. The associations between CHD risk and fifths of L p(a) levels were assessed before and after adjustment for KIV repeats and, conversely, the associations between CHD risk and fifths of KIV repeats were assessed before and after adjustment for L p(a) levels. Results Individuals in the top fifth of L p(a) levels had more than a twofold higher risk of CHD compared with those in the bottom fifth, and this association was materially unaltered after adjustment for KIV repeats [odds ratio ( OR ) 2.05, 95% confidence interval ( CI ) 1.38–3.04, P < 0.001]. Furthermore, almost all of the excess risk was restricted to the two‐fifths of the population with the highest L p(a) levels. Individuals in the bottom fifth of KIV repeats had about a twofold higher risk of CHD compared with those in the top fifth, but this association was no longer significant after adjustment for L p(a) levels ( OR 1.13, 95% CI 0.77–1.66, P = 0.94). Conclusions The effect of KIV repeats on CHD risk is mediated through their impact on L p(a) levels, suggesting that absolute levels of L p(a), rather than apo(a) isoform size, are the main determinant of CHD risk." @default.
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• W2095396265 date "2014-02-05" @default.
• W2095396265 modified "2023-10-02" @default.
• W2095396265 title "Impact of lipoprotein(a) levels and apolipoprotein(a) isoform size on risk of coronary heart disease" @default.
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• W2095396265 doi "https://doi.org/10.1111/joim.12187" @default.
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