Lipoprotein(a) and coronary heart disease - Meta-analysis of prospective studies

被引:708
作者
Danesh, J [1 ]
Collins, R
Peto, R
机构
[1] Univ Oxford, Radcliffe Infirm, CTSU, Oxford OX2 6HE, England
[2] Univ Oxford, Radcliffe Infirm, Epidemiol Studies Unit, Nuffield Dept Clin Med, Oxford OX2 6HE, England
关键词
lipoproteins; coronary disease; meta-analysis;
D O I
10.1161/01.CIR.102.10.1082
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background -Studies of the association between the plasma concentration of lipoprotein(a) [Lp(a)] and coronary heart disease (CHD) have reported apparently conflicting findings. We report a meta-analysis of the prospective studies with at least 1 year of follow-up published before 2000, Methods and Results-The following information was abstracted for each study: geographical location of study, size, type of cohort (population-based or selected because of previous disease), mean age, follow-up duration, blood storage temperature and duration, assay methods, degree of adjustment for potential confounders, and relationship of baseline Lp(a) measurement with subsequent CHD risk. There were 5436 deaths from CHD or nonfatal myocardial infarctions during a weighted mean follow-up of 10 years in the 27 eligible studies. Comparison of individuals in the top third of baseline plasma Lp(a) measurements with those in the bottom third in each study yielded a combined risk ratio of 1.6 (95% CI 1.4 to 1.8, 2 p <0.00001), with similar findings when the analyses were restricted to the 18 studies of general populations (combined risk ratio 1.7, 95% CI 1.4 to 1.9; 2p <0.00001). Despite differences among studies in blood storage techniques and assay methods, there was no significant heterogeneity among the results from the 18 population-based studies or among those from the 9 studies of patients with previous disease. Lp(a) was only weakly correlated with classical vascular risk factors, and adjustment for those that had been recorded made little difference to the reported risk ratios. Conclusions-These prospective studies demonstrate a clear association between Lp(a) and CHD, but further studies are needed to determine the extent to which this is causal.
引用
收藏
页码:1082 / 1085
页数:4
相关论文
共 37 条
  • [1] RELATION OF SERUM HOMOCYSTEINE AND LIPOPROTEIN(A) CONCENTRATIONS TO ATHEROSCLEROTIC DISEASE IN A PROSPECTIVE FINNISH POPULATION-BASED STUDY
    ALFTHAN, G
    PEKKANEN, J
    JAUHIAINEN, M
    PITKANIEMI, J
    KARVONEN, M
    TUOMILEHTO, J
    SALONEN, JT
    EHNHOLM, C
    [J]. ATHEROSCLEROSIS, 1994, 106 (01) : 9 - 19
  • [2] Hypertriglyceridemia and elevated lipoprotein(a) are risk factors for major coronary events in middle-aged men
    Assmann, G
    Schulte, H
    vonEckardstein, A
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1996, 77 (14) : 1179 - 1184
  • [3] HAS LIPOPROTEIN LITTLE-(A) SHRUNK
    BARNATHAN, ES
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 270 (18): : 2224 - 2225
  • [4] Berg K, 1997, CLIN GENET, V52, P254
  • [5] Elevated plasma lipoprotein(a) and coronary heart disease in men aged 55 years and younger - A prospective study
    Bostom, AG
    Cupples, LA
    Jenner, JL
    Ordovas, JM
    Seman, LJ
    Wilson, PWF
    Schaefer, EJ
    Castelli, WP
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1996, 276 (07): : 544 - 548
  • [6] A PROSPECTIVE INVESTIGATION OF ELEVATED LIPOPROTEIN(A) DETECTED BY ELECTROPHORESIS AND CARDIOVASCULAR-DISEASE IN WOMEN - THE FRAMINGHAM HEART-STUDY
    BOSTOM, AG
    GAGNON, DR
    CUPPLES, LA
    WILSON, PWF
    JENNER, JL
    ORDOVAS, JM
    SCHAEFER, EJ
    CASTELLI, WP
    [J]. CIRCULATION, 1994, 90 (04) : 1688 - 1695
  • [7] Is lipoprotein(a) an independent risk factor for ischemic heart disease in men?: The Quebec cardiovascular study
    Cantin, B
    Gagnon, F
    Moorjani, S
    Després, JP
    Lamarche, B
    Lupien, PJ
    Dagenais, GR
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1998, 31 (03) : 519 - 525
  • [8] Clarke R, 1999, AM J EPIDEMIOL, V150, P341
  • [9] A PROSPECTIVE-STUDY OF OBESITY, LIPIDS, APOLIPOPROTEINS AND ISCHEMIC-HEART-DISEASE IN WOMEN
    COLEMAN, MP
    KEY, TJA
    WANG, DY
    HERMON, C
    FENTIMAN, IS
    ALLEN, DS
    JARVIS, M
    PIKE, MC
    SANDERS, TAB
    [J]. ATHEROSCLEROSIS, 1992, 92 (2-3) : 177 - 185
  • [10] Craig WY, 1998, CLIN CHEM, V44, P2301