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April 13, 1994

Lipoprotein(a) and Risk of Myocardial Infarction

Author Affiliations

The University of Texas Southwestern Medical Center at Dallas

JAMA. 1994;271(14):1077. doi:10.1001/jama.1994.03510380033019

To the Editor.  —In their recent study, Ridker et al1 found no evidence of an association between plasma lipoprotein(a) concentration and risk of future myocardial infarction (MI). While this is an important addition to the literature, being the largest prospective study to date, a number of details omitted from the article limit the ability of the interested reviewer to assess its full significance.Neither the racial breakdown nor the age range of the nested study group is given. It is insufficient to state that the cases and controls were predominantly white when it has been well recognized that ethnic origin plays a significant role in the determination of plasma Lp(a) concentrations.2 The age distribution of the groups would not necessarily affect the Lp(a) levels but may significantly influence the observed association between plasma Lp(a) concentration and risk of MI. Previous studies have reported that the association between plasma