TY - JOUR
T1 - Lipoprotein(a) and the Risk for Coronary Heart Disease and Ischemic Stroke Events Among Black and White Adults With Cardiovascular Disease
AU - Colantonio, Lisandro D.
AU - Bittner, Vera
AU - Safford, Monika M.
AU - Marcovina, Santica
AU - Brown, Todd M.
AU - Jackson, Elizabeth A.
AU - Li, Mei
AU - López, J. Antonio G.
AU - Monda, Keri L.
AU - Plante, Timothy B.
AU - Kent, Shia T.
AU - Muntner, Paul
AU - Rosenson, Robert S.
N1 - Funding Information:
Dr Colantonio receives research support from Amgen Inc. Dr Bittner was a national coordinator for Astra Zeneca (Long-Term Outcomes Study to Assess Statin Residual Risk with Epanova in High Cardiovascular Risk Patients with Hypertriglyceridemia [STRENGTH] trial) and DalCor (Dalgene trial) and is a national coordinator for Esperion (The Cholesterol Lowering via Bempedoic acid, an ACL-Inhibiting Regimen [CLEAR] outcomes study), all contracted between University of Alabama at Birmingham (UAB) and the trial sponsors; is a Steering Committee member for the Odyssey Outcomes Trial through a contract between UAB and Sanofi/Regeneron; serves as the site principal investigator for a contract between UAB and Novartis (HPS-4 TIMI 65 ORION-4 trial); is a consultant for Pfizer and is a co-investigator on a contract between the UAB School of Public Health and Amgen. Dr Safford receives research support from Amgen. Dr Marcovina is a consultant for Roche Diagnostics, Denka Seiken, and Novartis; and receives research support from contracts between Amgen and Medpace. Dr Plante receives research support from Amgen Inc (site principal investigator for STRENGTH trial). Dr Jackson receives research funding from the National Institutes of Health and Amgen; is an editorial board member of Circulation: Cardiovascular Quality and Outcomes; is a consultant for the American College of Cardiology and McKesson, Inc; and receives royalties from UpToDate. Drs López, Monda, and Kent are employees and shareholders of Amgen Inc. Dr Muntner receives research support and consulting fees from Amgen Inc. Dr Rosenson receives research support from Amgen, Arrowhead, Lilly, Novartis, and Regeneron; consulting fees from Amgen, Amryt, CVS Caremark, C5,
Funding Information:
The design and conduct of the current analysis, measurement of lipoprotein(a), apolipoprotein B, interpretation of the results, and preparation of the article were supported through a research grant from Amgen Inc (Thousand Oaks, CA). The academic authors conducted all analyses and maintained the rights to publish this article. The REGARDS (Reasons for Geographic and Racial Differences in Stroke) study is supported by cooperative agreement U01 NS041588 cofunded by the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institute on Aging (NIA), National Institutes of Health, Department of Health and Human Services. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NINDS or the NIA. Representatives of the NINDS were involved in the review of the article but were not directly involved in the collection, management, analysis, or interpretation of the data. Additional funding was provided by grants R01 HL080477 and K24 HL111154 from the National Heart, Lung, and Blood Institute (NHLBI). Representatives from the NHLBI did not have any role in the design and conduct of the study, the collection, management, analysis, and interpretation of the data, or the preparation or approval of the article.
Publisher Copyright:
© 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2022/6/7
Y1 - 2022/6/7
N2 - 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 ex-perienced 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 (P 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 <2 mg/L was 1.31 (95% CI, 0.99–1.73) and 1.23 (95% CI, 0.85–1.80), respectively (P value comparing HRs, 0.836), among Black participants, and 1.07 (95% CI, 0.91–1.27) and 1.36 (95% CI, 1.10– 1.70), respectively (P value comparing HRs, 0.088), among White participants. There was no evidence that the association between lipoprotein(a) and CHD events differed by statin use. There was no evidence of an association between lipoprotein(a) and ischemic stroke events among Black or White participants. CONCLUSIONS: Higher lipoprotein(a) levels were associated with an increased risk for CHD events in Black and White adults with ASCVD.
AB - 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 ex-perienced 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 (P 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 <2 mg/L was 1.31 (95% CI, 0.99–1.73) and 1.23 (95% CI, 0.85–1.80), respectively (P value comparing HRs, 0.836), among Black participants, and 1.07 (95% CI, 0.91–1.27) and 1.36 (95% CI, 1.10– 1.70), respectively (P value comparing HRs, 0.088), among White participants. There was no evidence that the association between lipoprotein(a) and CHD events differed by statin use. There was no evidence of an association between lipoprotein(a) and ischemic stroke events among Black or White participants. CONCLUSIONS: Higher lipoprotein(a) levels were associated with an increased risk for CHD events in Black and White adults with ASCVD.
KW - adults
KW - coronary heart disease
KW - lipoprotein(a)
KW - secondary prevention
KW - stroke
UR - http://www.scopus.com/inward/record.url?scp=85131702422&partnerID=8YFLogxK
U2 - 10.1161/JAHA.121.025397
DO - 10.1161/JAHA.121.025397
M3 - Article
C2 - 35621195
AN - SCOPUS:85131702422
VL - 11
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 11
M1 - e025397
ER -