Predictive value of lipoprotein(a) for coronary artery disease

OBJECTIVE: The predictive Value of lipoprotein(a), Lp(a), for coronary artery disease, is strongly suspected, though unproven. The normal serum level is 0.3 g/l. We searched for correlations between serum Lp(a) levels and coronary artery disease in a population of patients hospitalized in a general cardiology unit METHOD: Serum Lp(a) was assayed in ail patients consecutively hospitalized during 1994 in the valence hospital cardiology unit Two groups were distinguished: patients with coronary artery disease (n=444) and those presumed free of coronary artery disease (n=555). Coronography were performed when required. Serum Lp(a) levels were compared for the following variables. age, sex, smoking habits, blood pressure, total cholesterol, HDL and LDL-cholesterol, triglycerides and apolipoproteins Al and A2. Univariate, then multivariate analysis were performed first patients of all ages, then for those aged more and less than 60 years. RESULTS: Univariate analysis demonstrated that Lp(a) > 0.3 g/l was associated with coronary heart disease (OR = 1.33; p = 0.03), although this correlation was no longer significant after adjustment for other known risk factors (OR=1.28; p = 0.07), except in the subgroup of patients over 60 years of age (OR=1.37; p=0.04). CONCLUSION: There was a non-significant trend favoring an association between serum ip(a) level > 0.3 g/l and the development of coronary artery disease.