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October 18, 1995

Lipoprotein(a) Concentration and Risk of Atherothrombotic Disease-Reply

Author Affiliations

Brigham and Women's Hospital Boston, Mass

JAMA. 1995;274(15):1198-1199. doi:10.1001/jama.1995.03530150022021

In Reply.  —We agree with Drs Craig and Bostom that apparent differences in outcome from available prospective studies of Lp(a) and atherothrombotic disease deserve close attention. We also believe, however, that differences in the results of available studies are in fact more apparent than real. For example, the case and control distributions in the "positive" Lipid Research Clinics data1 and the "null" Physicians Health Study data2,3 are almost identical. Specifically, the narrow 95% confidence interval for the risk estimate associated with a 10 mg/dL increase in Lp(a) in the Lipid Research Clinics analysis (1.03 to 1.20) overlaps that of the equally narrow 95% confidence interval of the Physicians' Health Study analysis (0.95 to 1.13). Moreover, the estimates of the relative risks associated with such a change in Lp(a) in these two studies are 1.12 and 1.03, respectively. Since the distribution of Lp(a) is markedly skewed in most populations

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