Circulation, Vol 86, 475-482, Copyright © 1992 by American Heart Association
MD Cressman, RJ Heyka, EP Paganini, J O'Neil, CI Skibinski and HF Hoff
BACKGROUND. Although serum lipoprotein(a) [Lp(a)] is an independent risk
factor for atherosclerosis in the general population and Lp(a) levels are
increased in hemodialysis patients, an association of Lp(a) with the risk
of clinical events attributed to atherosclerosis has not been established
in the chronic hemodialysis patient population. We therefore determined the
association between Lp(a) levels and the risk of clinical events of
presumed atherosclerotic etiology in a prospective study of an outpatient
hemodialysis population. METHODS AND RESULTS. Lp(a) was measured by
radioimmunoassay in a baseline cardiovascular disease risk assessment in a
consecutive series of 129 hemodialysis patients. The relation between
baseline Lp(a) and clinical events of presumed atherosclerotic etiology was
determined during 48 months of follow-up. Hemodialysis patients had a
median Lp(a) concentration that was approximately four times as high as the
median Lp(a) concentration in normal controls and twice as high as the
levels in controls with angiographic evidence of coronary artery disease
[median Lp(a), 38.4 versus 16.9 mg/dl; p less than 0.001]. Baseline Lp(a)
levels were no different in participants with or with no history of a
previous clinical event at the time of the baseline examination. However,
baseline Lp(a) concentration (p less than 0.001) and a history of
atherosclerotic clinical events (p = 0.001) were associated with clinical
events during the period of follow-up. In contrast, baseline serum total
cholesterol, triglyceride, high density lipoprotein cholesterol, low
density lipoprotein cholesterol, age, gender, race, or duration of
hemodialysis were unrelated to this risk in the prospective study. Stepwise
multiple logistic regression analysis demonstrated that serum Lp(a)
concentration (p = 0.001) and the presence of a previous clinical event (p
= 0.004) were the only independent contributors to the risk of a clinical
event during the period of follow-up. CONCLUSIONS. Lp(a) is an independent
risk factor for clinical events attributed to atherosclerotic
cardiovascular disease in patients receiving chronic hemodialysis treatment
of end-stage renal disease.
ARTICLES
Lipoprotein(a) is an independent risk factor for cardiovascular disease in hemodialysis patients
Department of Heart and Hypertension Research, Cleveland Clinic Foundation, OH 44195-5069.
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|
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|
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|
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