The significance of high levels of lipoprotein (a) compared with established risk factors in premature coronary artery disease: differences between men and women

• Published in: Atherosclerosis 1999-05, Vol.144 (1), p.221-228
• Main Authors: Hahmann, Harry W., Schätzer-Klotz, Dorothea, Bunte, Thomas, Becker, Dieter, Schieffer, Hermann J.
• Format: Article
• Language: English
• Subjects: Adult; Age Distribution; Age of Onset; Aged; Biological and medical sciences; Biomarkers - analysis; Cardiology. Vascular system; Coronary Angiography; Coronary artery disease; Coronary Disease - blood; Coronary Disease - diagnosis; Coronary Disease - epidemiology; Coronary heart disease; Early atherosclerosis; Female; Germany - epidemiology; Heart; Humans; Lipoprotein (a); Lipoprotein(a) - blood; Lipoprotein(a) - metabolism; Male; Medical sciences; Middle Aged; Risk Factors; Risk factors in women; Sensitivity and Specificity; Sex Distribution
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/S0021-9150(99)00057-X

It was shown in a series of studies that increased lipoprotein (a) concentration is a strong and independent risk factor for coronary artery disease. The goal of this study was to determine the significance of elevated lipoprotein (a) levels for the existence and the early manifestation of coronary artery disease by systematically recording cardiovascular risk factors in diagnostic coronary angiographies in a larger group of patients, whereby particular attention was paid to sex-specific differences. In 1011 consecutive patients who underwent coronary angiography (731 men, 280 women, mean age 59±10 years), fasting blood samples were taken immediately before the angiographies to determine the levels of cholesterol, low density lipoprotein-, high density lipoprotein-cholesterol, triglycerides and lipoprotein (a). In addition, further risk factors were qualitatively recorded. The data evaluation was carried out using the SPSSx software package univariately and multivariately with stepwise discriminant analysis. In 231 patients (144 men, 87 women) either no or only discrete coronary findings appeared, while in 780 cases (587 men, 193 women) coronary artery disease with stenoses >50% were found. Women with coronary artery disease were significantly older than men and demonstrated higher lipoprotein levels. Women as well as men with coronary artery disease differed from healthy controls by having higher levels of lipoprotein (a) and other lipoproteins, lipoprotein (a) having the smallest error probability ( P