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Author Notes:

Briana T. Costello, MD 657 W. Fulton Street, Unit 703 Chicago, IL 60661 Briana.costello.10@gmail.com

The authors acknowledge Li Shien Low; Marcel Gout; Nicole Pohlman; Ben Gastevich; and Rasa Kazlauskaite, MD for their assistance with data collection, risk calculation, and statistics.

Rami Doukky serves on the advisory board for and has received research funding from Astellas Pharma.

The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Subject:

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Cardiovascular System & Cardiology
  • CORONARY-HEART-DISEASE
  • ARTERY-DISEASE
  • ELEVATED LIPOPROTEIN(A)
  • APOLIPOPROTEIN(A) GENE
  • PLASMA LIPOPROTEIN(A)
  • PREDICTION
  • THERAPY
  • METAANALYSIS
  • MARKERS
  • LP(A)

Lipoprotein(a) and Increased Cardiovascular Risk in Women

Tools:

Journal Title:

Clinical Cardiology

Volume:

Volume 39, Number 2

Publisher:

, Pages 96-102

Type of Work:

Article | Final Publisher PDF

Abstract:

Background: Approximately 20% of the population has elevated circulating levels of lipoprotein(a) (Lp[a]), one of the most robust predictors of cardiovascular disease risk. This is particularly true for women. Hypothesis: Many female patients with "normal" traditional risk factors or low atherosclerotic cardiovascular disease (ASCVD) risk scores may harbor high risk related to elevated levels of Lp(a). Methods: A retrospective, cross-sectional study of consecutive female patients presenting to Heart Centers for Women was performed. Discordance between low-density lipoprotein cholesterol (LDL-C) and Lp(a) was determined. The ASCVD risk and Reynolds Risk Score models A (RRS-A) and B (RRS-B) were calculated, and level of agreement in patients meeting treatment threshold (≥7.5% for ASCVD, ≥10% for RRS-A and RRS-B) were compared. Results: Among 713 women, 290 (41%) had elevated Lp(a); however, LDL-C and Lp(a) were weakly correlated (r = 0.08). Significant discordance was observed between abnormal LDL-C and Lp(a) levels (McNemar P = 0.03). There was moderate correlation between RRS-A and ASCVD risk (r = 0.71, P < 0.001), and Bland-Altman plot showed diminished correlation with increased risk. More patients met treatment threshold by ASCVD risk estimation, but nearly 1 out of 20 patients met treatment threshold by RRS-A but not ASCVD score. Conclusions: There is high prevalence of elevated Lp(a) among women presenting to Heart Centers for Women. Although traditional risk markers such as elevated LDL-C or high ASCVD risk may be absent in some women, elevated Lp(a) may identify patients who may benefit from aggressive risk-factor modification and pharmacologic therapy.

Copyright information:

© 2016 Wiley Periodicals, Inc.

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