HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Lipoprotein(a) and prevalent cardiovascular disease in a dialysis population: The Choices for Healthy Outcomes in Caring for ESRD (CHOICE) study.

AbstractBACKGROUND:
Levels of lipoprotein(a) [Lp(a)], an atherogenic lipoprotein, are elevated in patients with end-stage renal disease and inversely related to the size of apolipoprotein(a) [apo(a)], a glycoprotein bound to Lp(a). We studied the association of Lp(a) level and apo(a) size with prevalent atherosclerotic cardiovascular disease (ASCVD) in 871 incident dialysis patients (261 blacks, 565 whites, 45 other).
METHODS:
Lp(a) was measured by an apo(a) size-independent enzyme-linked immunoassay; and apo(a) size was measured by sodium dodecyl sulfate-agarose gel electrophoresis. Prevalent ASCVD, derived from medical records, was defined as coronary heart disease or cerebral or peripheral vascular disease. Adjustment variables included age, sex, race, dialysis modality, diabetes, serum creatinine level, albumin level, and low-density lipoprotein cholesterol level.
RESULTS:
ASCVD prevalence was 58%. Median Lp(a) levels for those with compared with those without ASCVD were 38 versus 35 nmol/L for whites (P = 0.49) and 100 versus 74 nmol/L for blacks, respectively (P = 0.35). Lp(a) level was associated with ASCVD among those younger than 60 years (odds ratio [OR] for +1 interquartile range of Lp(a), 1.5; P = 0.02), but not among those 60 years and older (OR, 1.0; P = 0.82; P(interaction) by age, 0.08). ORs were 1.3 for all whites (P = 0.03) and 1.1 for all blacks (P = 0.87; P(interaction)by race = 0.53). ORs of ASCVD were 1.7 for whites younger than 60 years (P = 0.01) and 1.2 for blacks younger than 60 years (P = 0.77; P(interaction) by race = 0.42). No association between apo(a) isoform size and ASCVD was present.
CONCLUSION:
In an incident dialysis cohort, Lp(a) level was associated with prevalent ASCVD among whites younger than 60 years, but not among blacks or those older than 60 years. Apo(a) isoform size was not associated with prevalent ASCVD. These data suggest that baseline ASCVD is unlikely to strongly confound the potential associations of Lp(a) level and prospectively ascertained ASCVD among incident dialysis patients.
AuthorsJ Craig Longenecker, Josef Coresh, Santica M Marcovina, Neil R Powe, Andrew S Levey, Federico Giaculli, Nancy E Fink, Michael J Klag
JournalAmerican journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 42 Issue 1 Pg. 108-16 (Jul 2003) ISSN: 1523-6838 [Electronic] United States
PMID12830462 (Publication Type: Journal Article, Multicenter Study, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Apolipoproteins A
  • Lipoprotein(a)
Topics
  • Adult
  • Age Distribution
  • Aged
  • Apolipoproteins A (blood)
  • Arteriosclerosis (blood, epidemiology)
  • Cohort Studies
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Kidney Failure, Chronic (blood, epidemiology, therapy)
  • Lipoprotein(a) (analysis)
  • Male
  • Middle Aged
  • Molecular Weight
  • Prevalence
  • Prospective Studies
  • Racial Groups
  • Renal Dialysis
  • Risk Factors
  • United States (epidemiology)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: