Despite 2-3 times higher Lp(a), Black adults show no link between Lp(a) and coronary calcium, the Dallas Heart Study of 761 Black and 527 white adults (Circulation 2005)

Original title: Lipoprotein(a) and apolipoprotein(a) isoforms: no association with coronary artery calcification in the Dallas Heart Study

Circulation · 21 March 2005 · 7

Guerra R, Yu Z, Marcovina S, Peshock R, Cohen JC, Hobbs HH

This study examined the relationship between Lp(a), apolipoprotein(a) isoform size, and coronary artery calcium (CAC) in 761 Black and 527 white adults (men over 40, women over 45) from a population-based sample, given that Black individuals have 2- to 3-fold higher Lp(a) than white individuals without a correspondingly higher coronary event rate. No relationship was found between Lp(a), apo(a) isoform size, or their combination and CAC in either race, though all 7 Black men with Lp(a) above 300 micromol/L were CAC-positive. White individuals with high Lp(a) plus elevated LDL cholesterol (men), low HDL cholesterol (both sexes), or smoking (women) had higher CAC prevalence, but no such joint effects were found in Black individuals. The findings show no consistent independent relationship between Lp(a) or apo(a) isoform size and coronary calcium in either white or Black adults.

Original abstract

Background: Elevated plasma levels of lipoprotein(a) [Lp(a)] are an independent risk factor for cardiovascular disease in whites. Blacks have 2- to 3-fold higher plasma levels of Lp(a) than whites and yet do not have a correspondingly higher rate of coronary events. It remains unclear whether elevated plasma levels of Lp(a) are an independent risk factor for coronary atherosclerosis in individuals of African descent.

Methods And Results: The relationship between plasma levels of Lp(a), apolipoprotein(a) isoform sizes, and the presence of coronary calcium was examined in 761 blacks and 527 whites (men aged >40 years, women aged >45 years) from a population-based sample. No relationship was found between plasma levels of Lp(a), apolipoprotein(a) isoform size, or a combination of these 2 variables and coronary artery calcium (CAC) in whites or blacks. No correlation was observed between plasma levels of Lp(a) and coronary calcium scores in any group, although all black men with very high plasma levels of Lp(a) (>300 micromol/L; n=7) were CAC-positive. Whites with high plasma levels of Lp(a) plus elevated plasma levels of LDL cholesterol (men) or reduced levels of HDL cholesterol (men and women) or who smoked (women) had a higher prevalence of CAC. In contrast, no joint effects between plasma levels of Lp(a) and other cardiovascular risk factors on coronary calcium were found in blacks.

Conclusions: No consistent independent relationship between plasma levels of Lp(a) or apolipoprotein(a) isoform size and coronary calcium was found in whites or blacks.

Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.