Lipoprotein(a) and the Risk for Coronary Heart Disease and Ischemic Stroke Events Among Black and White Adults With Cardiovascular Disease

• Published in: Journal of the American Heart Association 2022-06, Vol.11 (11), p.e025397-e025397
• Main Authors: Colantonio, Lisandro D, Bittner, Vera, Safford, Monika M, Marcovina, Santica, Brown, Todd M, Jackson, Elizabeth A, Li, Mei, López, J Antonio G, Monda, Keri L, Plante, Timothy B, Kent, Shia T, Muntner, Paul, Rosenson, Robert S
• Format: Article
• Language: English
• Subjects: Adult; adults; Atherosclerosis; C-Reactive Protein; Cardiovascular Diseases; Coronary Disease - epidemiology; coronary heart disease; Humans; Ischemic Stroke - diagnosis; Ischemic Stroke - epidemiology; Lipoprotein(a); Original Research; Risk Factors; secondary prevention; stroke; Stroke - epidemiology
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.121.025397

Background It is unclear whether lipoprotein(a) is associated with coronary heart disease (CHD) and ischemic stroke events in White and Black adults with atherosclerotic cardiovascular disease (ASCVD). Methods and Results We conducted a case-cohort analysis, including Black and White REGARDS (Reasons for Geographic and Racial Differences in Stroke) study participants ≥45 years of age with prevalent ASCVD (ie, CHD or stroke) at baseline between 2003 and 2007. Baseline lipoprotein(a) molar concentration was measured in participants with ASCVD who experienced a CHD event by December 2017 (n=1166) or an ischemic stroke by September 2019 (n=492) and in a random subcohort of participants with prevalent ASCVD (n=1948). The hazard ratio (HR) for CHD events per 1 SD (1.5 units) higher log-transformed lipoprotein(a) was 1.26 (95% CI, 1.02-1.56) among Black participants and 1.16 (95% CI, 1.02-1.31) among White participants ( value comparing HRs, 0.485). The HR for CHD events per 1 SD higher log-lipoprotein(a) within subgroups with hs-CRP (high-sensitivity C-reactive protein) ≥2 and