• G H Dahlén, S R Srinivasan, H Stenlund, W A Wattigney, S Wall, and G S Berenson.
• Department of Clinical Chemistry, Umeå University Hospital, Sweden. gosta.h.dahlen@klinkemi.umu.se
• J. Intern. Med. 1998 Nov 1; 244 (5): 417424417-24.

ObjectiveTo determine the association of serum levels of lipoprotein (a) (Lp(a)) with coronary artery disease (CAD) in relation to other risk factor variables in black and white women.DesignRetrospective case-control study.SettingCommunity of Bogalusa, Louisiana and Cardiac Catheterization Laboratory at the Medical Center of Louisiana, New Orleans, USA.SubjectsThe study included 47 female cases (52% black; mean +/- SD age: 50.8 +/- 6.3 years) with confirmed myocardial infarction (MI) or at least 75% blockage of one or more major epicardial coronary arteries determined by angiography, and 55 controls (60% black; mean +/- SD age: 49.6 +/- 7.9 years) with no high grade obstructive lesion (< 50% blockage) and no history of CAD.Main Outcome MeasuresLipoprotein variables, homocysteine, body mass index and cigarette smoking.ResultsIn the whole group, mean values of Lp(a), total cholesterol, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (apoB) and very-low-density lipoprotein cholesterol (VLDL-C) were higher (P < 0.05-0.001) and apoA-I was lower (P < 0.05) in cases than in controls. The multivariate logistic regression analysis showed elevated levels of Lp(a) (> 500 mg L-1) and LDL-C (> 3.36 mmol L-1) as strong independent risk factors, with odds ratios (with 95% confidence intervals) of 13.6 (4.00-46.30) and 4.64 (1.31-16.49), respectively. ApoA-I, with an odds ratio of 0.11 (0.02-0.64), was a protective factor only at high levels (> 53.6 mumol L-1). Between races, significant odds ratios were noted in the black women for Lp(a) (OR = 15.98; P < 0.01) and LDL-C (OR = 7.69; P < 0.05) and in the white women for only Lp(a) (OR = 15.23; P < 0.01).ConclusionsLp(a) is an important risk factor for CAD both in black and in white women.

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