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Associations of Lipoprotein(a) Levels With Incident Atrial Fibrillation and Ischemic Stroke: The ARIC (Atherosclerosis Risk in Communities) Study.

TitleAssociations of Lipoprotein(a) Levels With Incident Atrial Fibrillation and Ischemic Stroke: The ARIC (Atherosclerosis Risk in Communities) Study.
Publication TypeJournal Article
Year of Publication2017
AuthorsAronis KN, Zhao D, Hoogeveen RC, Alonso A, Ballantyne CM, Guallar E, Jones SR, Martin SS, Nazarian S, Steffen BT, Virani SS
Secondary AuthorsMichos ED
JournalJ Am Heart Assoc
Date Published2017 Dec 15
KeywordsAtherosclerosis, Atrial Fibrillation, Biomarkers, Brain Ischemia, Coronary Artery Disease, Electrocardiography, Female, Follow-Up Studies, Humans, Incidence, Lipoprotein(a), Male, Middle Aged, Prospective Studies, Risk Assessment, Risk Factors, Survival Rate, Time Factors, United States

BACKGROUND: Lipoprotein(a) (Lp[a]) is proatherosclerotic and prothrombotic, causally related to coronary disease, and associated with other cardiovascular diseases. The association of Lp(a) with incident atrial fibrillation (AF) and with ischemic stroke among individuals with AF remains to be elucidated.

METHODS AND RESULTS: In the community-based ARIC (Atherosclerosis Risk in Communities) study cohort, Lp(a) levels were measured by a Denka Seiken assay at visit 4 (1996-1998). We used multivariable-adjusted Cox models to compare AF and ischemic stroke risk across Lp(a) levels. First, we evaluated incident AF in 9908 participants free of AF at baseline. AF was ascertained by electrocardiography at study visits, hospital () codes, and death certificates. We then evaluated incident ischemic stroke in 10 127 participants free of stroke at baseline. Stroke was identified by annual phone calls, hospital codes, and death certificates. The baseline age was 62.7±5.6 years. Median Lp(a) levels were 13.3 mg/dL (interquartile range, 5.2-39.7 mg/dL). Median follow-up was 13.9 and 15.8 years for AF and stroke, respectively. Lp(a) was not associated with incident AF (hazard ratio, 0.98; 95% confidence interval, 0.82-1.17), comparing those with Lp(a) ≥50 with those with Lp(a)

CONCLUSIONS: High Lp(a) levels were not associated with incident AF. Lp(a) levels were associated with increased ischemic stroke risk, primarily among individuals without AF but not in those with AF.

Alternate JournalJ Am Heart Assoc
PubMed ID29246963
PubMed Central IDPMC5779047
Grant List16EIA26410001 / AHA / American Heart Association-American Stroke Association / United States