The role of lipoprotein(a) [Lp(a)] in coronary heart disease (CHD), once considered to be well established, has recently been put into question. For example, in a prospective, nested case-control study of the Helsinki Heart Study participants, Jauhiainen et al1 found no significant increase in risk of CHD associated with higher levels of Lp(a) among 138 hyperlipidemic men who developed coronary events compared with 130 controls. A similar lack of association between Lp(a) and clinical CHD was reported by Simons et al2 from a cross-sectional analysis of 1202 men and 1512 women older than 60 years. The skewed and broad distribution of Lp(a) levels, ranging from 1.0 mg/dL (0.03 mmol/L) to 210.0 mg/dL (5.25 mmol/L), was strikingly similar in the two groups. Finally, in a report published recently in The JOURNAL involving the prospective Physicians' Health Study, Ridker et al3 found a "virtually identical" Lp(a) distribution among 296
Gurewich V, Mittleman M. Lipoprotein(a) in Coronary Heart Disease: Is It a Risk Factor After All? JAMA. 1994;271(13):1025–1026. doi:10.1001/jama.1994.03510370077037
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