Epidemiology
Lp(a) above 30 mg/dL doubles coronary disease risk in women, tripling when combined with high fibrinogen or CRP, the Nurses' Health Study of 32,826 women (Eur Heart J 2005)
Original title: Lipoprotein (a) and coronary heart disease among women: beyond a cholesterol carrier?
This study examined Lp(a) role in coronary heart disease (CHD) using a Kringle-independent assay in 32,826 women from the Nurses' Health Study, documenting 228 CHD events over 8 years, each matched with two controls. After adjusting for standard risk factors, Lp(a) at or above 30 mg/dL carried an odds ratio of 1.9 for CHD (95% CI 1.3-3.0) versus below 30 mg/dL. Women with both high Lp(a) (at or above 30 mg/dL) and high fibrinogen (at or above 400 mg/dL) had an odds ratio of 3.2 for CHD (95% CI 1.6-6.5, P for interaction=0.05) versus both low, and those with both high Lp(a) and high CRP (at or above 3 mg/L) had an odds ratio of 3.67 (95% CI 2.03-6.64, P for interaction=0.06) versus both low. The findings show Lp(a) above 30 mg/dL doubles CHD risk in women, an effect amplified by concurrent high fibrinogen or CRP, suggesting Lp(a) risk may involve thrombosis and inflammation beyond its cholesterol content.
Original abstract
Aims: With its homology with plasminogen, lipoprotein(a) [Lp(a)] may be related to thrombosis and inflammation. We assessed the role of Lp(a) in coronary heart diseases (CHD) by a recently developed assay that is not affected by the plasminogen-like Kringle-type-2 repeats.
Methods And Results: Of 32 826 women from the Nurses' Health Study, who provided blood at baseline, we documented 228 CHD events during 8 years of follow-up. Each case was compared with two matched controls. In a multivariable model adjusted for body mass index, family history, hypertension, diabetes, post-menopausal hormone use, physical activity, blood drawing characteristics, and alcohol intake, the odd ratio (OR) for Lp(a) levels > or =30 mg/dL was 1.9(95% CI: 1.3-3.0) when compared with those with Lp(a)<30 mg/dL. Women with high levels of both Lp(a) (> or =30 mg/dL) and fibrinogen (> or =400 mg/dL) had an OR of 3.2(95% CI: 1.6-6.5) for CHD, when compared with the combination of low levels (P interaction=0.05). Women with high levels of both Lp(a) and C-reactive protein (> or =3 mg/L) had an OR of 3.67(95% CI: 2.03-6.64) for CHD, when compared with the combination of low levels (P interaction=0.06).
Conclusion: Lp(a) levels >30 mg/dL are associated with twice the risk of CHD events among women and may be related to thrombosis and inflammation.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.