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The association of lipoprotein(a) with incident heart failure hospitalization: Atherosclerosis Risk in Communities study.
Atherosclerosis. 2017 07; 262:131-137.A

Abstract

BACKGROUND AND AIMS

Lipoprotein(a) [Lp(a)] is a proatherogenic lipoprotein associated with coronary heart disease, ischemic stroke, and more recently aortic stenosis and heart failure (HF). We examined the association of Lp(a) levels with incident HF hospitalization in the Atherosclerosis Risk in Communities (ARIC) study. We also assessed the relationship between Lp(a) levels and arterial stiffness as a potential mechanism for development of HF.

METHODS

Lp(a) was measured in 14,154 ARIC participants without prevalent HF at ARIC visit 1 (1987-1989). The association of Lp(a) quintiles with incident HF hospitalization was assessed using Cox proportional-hazards models. Arterial stiffness parameters were stratified based on Lp(a) quintiles, and p-trend was calculated across ordered groups.

RESULTS

At a median follow-up of 23.4 years, there were 2605 incident HF hospitalizations. Lp(a) levels were directly associated with incident HF hospitalization in models adjusted for age, race, gender, systolic blood pressure, history of hypertension, diabetes, smoking status, body mass index, heart rate, and high-density lipoprotein cholesterol (quintile 5 vs. quintile 1: hazard ratio [HR] 1.24, 95% confidence interval [CI] 1.09-1.41; p-trend across increasing quintiles <0.01), but not after excluding prevalent and incident myocardial infarction cases (HR 1.07, 95% CI 0.91-1.27; p-trend = 0.70). When adjusted for age, gender, and race, Lp(a) quintiles were not significantly associated with arterial stiffness parameters.

CONCLUSIONS

Increased Lp(a) levels were associated with increased risk of incident HF hospitalization. After excluding prevalent and incident myocardial infarction, the association was no longer significant. Lp(a) levels were not associated with arterial stiffness parameters.

Authors+Show Affiliations

Department of Medicine, Baylor College of Medicine, Houston, TX, USA.Mid-America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA.Center for Cardiovascular Disease Prevention, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.Center for Cardiovascular Disease Prevention, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.Center for Cardiovascular Disease Prevention, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.Center for Cardiovascular Disease Prevention, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.Johns Hopkins University School of Medicine, Baltimore, MD, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, NC, USA.The University of Texas Health Science Center at Houston, Houston, TX, USA; Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA.Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.Center for Cardiovascular Disease Prevention, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.Center for Cardiovascular Disease Prevention, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA. Electronic address: cmb@bcm.edu.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

28554015

Citation

Agarwala, Anandita, et al. "The Association of Lipoprotein(a) With Incident Heart Failure Hospitalization: Atherosclerosis Risk in Communities Study." Atherosclerosis, vol. 262, 2017, pp. 131-137.
Agarwala A, Pokharel Y, Saeed A, et al. The association of lipoprotein(a) with incident heart failure hospitalization: Atherosclerosis Risk in Communities study. Atherosclerosis. 2017;262:131-137.
Agarwala, A., Pokharel, Y., Saeed, A., Sun, W., Virani, S. S., Nambi, V., Ndumele, C., Shahar, E., Heiss, G., Boerwinkle, E., Konety, S., Hoogeveen, R. C., & Ballantyne, C. M. (2017). The association of lipoprotein(a) with incident heart failure hospitalization: Atherosclerosis Risk in Communities study. Atherosclerosis, 262, 131-137. https://doi.org/10.1016/j.atherosclerosis.2017.05.014
Agarwala A, et al. The Association of Lipoprotein(a) With Incident Heart Failure Hospitalization: Atherosclerosis Risk in Communities Study. Atherosclerosis. 2017;262:131-137. PubMed PMID: 28554015.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association of lipoprotein(a) with incident heart failure hospitalization: Atherosclerosis Risk in Communities study. AU - Agarwala,Anandita, AU - Pokharel,Yashashwi, AU - Saeed,Anum, AU - Sun,Wensheng, AU - Virani,Salim S, AU - Nambi,Vijay, AU - Ndumele,Chiadi, AU - Shahar,Eyal, AU - Heiss,Gerardo, AU - Boerwinkle,Eric, AU - Konety,Suma, AU - Hoogeveen,Ron C, AU - Ballantyne,Christie M, Y1 - 2017/05/12/ PY - 2017/02/27/received PY - 2017/04/21/revised PY - 2017/05/11/accepted PY - 2017/5/30/pubmed PY - 2018/1/30/medline PY - 2017/5/30/entrez KW - Heart failure KW - Lipoproteins KW - Risk factors KW - Risk prediction SP - 131 EP - 137 JF - Atherosclerosis JO - Atherosclerosis VL - 262 N2 - BACKGROUND AND AIMS: Lipoprotein(a) [Lp(a)] is a proatherogenic lipoprotein associated with coronary heart disease, ischemic stroke, and more recently aortic stenosis and heart failure (HF). We examined the association of Lp(a) levels with incident HF hospitalization in the Atherosclerosis Risk in Communities (ARIC) study. We also assessed the relationship between Lp(a) levels and arterial stiffness as a potential mechanism for development of HF. METHODS: Lp(a) was measured in 14,154 ARIC participants without prevalent HF at ARIC visit 1 (1987-1989). The association of Lp(a) quintiles with incident HF hospitalization was assessed using Cox proportional-hazards models. Arterial stiffness parameters were stratified based on Lp(a) quintiles, and p-trend was calculated across ordered groups. RESULTS: At a median follow-up of 23.4 years, there were 2605 incident HF hospitalizations. Lp(a) levels were directly associated with incident HF hospitalization in models adjusted for age, race, gender, systolic blood pressure, history of hypertension, diabetes, smoking status, body mass index, heart rate, and high-density lipoprotein cholesterol (quintile 5 vs. quintile 1: hazard ratio [HR] 1.24, 95% confidence interval [CI] 1.09-1.41; p-trend across increasing quintiles <0.01), but not after excluding prevalent and incident myocardial infarction cases (HR 1.07, 95% CI 0.91-1.27; p-trend = 0.70). When adjusted for age, gender, and race, Lp(a) quintiles were not significantly associated with arterial stiffness parameters. CONCLUSIONS: Increased Lp(a) levels were associated with increased risk of incident HF hospitalization. After excluding prevalent and incident myocardial infarction, the association was no longer significant. Lp(a) levels were not associated with arterial stiffness parameters. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/28554015/The_association_of_lipoprotein_a__with_incident_heart_failure_hospitalization:_Atherosclerosis_Risk_in_Communities_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(17)30217-4 DB - PRIME DP - Unbound Medicine ER -