Published Online
on May 4, 2006

A more recent version of this article appeared on June 1, 2006

This Article Full Text (PDF) All Versions of this Article: 37/6/1407    most recent 01.STR.0000222666.21482.b6v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ohira, T. Articles by Folsom, A. R. Search for Related Content PubMed PubMed Citation Articles by Ohira, T. Articles by Folsom, A. R. Related Collections Coagulation and fibronolysis Lipid and lipoprotein metabolism Risk Factors Acute Cerebral Infarction Related Article

Submitted on January 6, 2006
Revised on February 10, 2006
Accepted on February 24, 2006

Lipoprotein(a) and Incident Ischemic Stroke. The Atherosclerosis Risk in Communities (ARIC) Study

Tetsuya Ohira MD; Pamela J. Schreiner PhD; Joel D. Morrisett PhD; Lloyd E. Chambless PhD; Wayne D. Rosamond PhD; and Aaron R. Folsom MD^*

From the Division of Epidemiology and Community Health (T.O., P.J.S., A.R.F.), University of Minnesota, Minneapolis, Minn; the Osaka Medical Center for Health Science and Promotion (T.O.), Osaka, Japan; the Departments of Medicine and Biochemistry (J.D.M.), Baylor College of Medicine, Houston, Tex; and the Departments of Biostatistics (L.E.C.) and Epidemiology (W.D.R.), University of North Carolina, Chapel Hill, NC.

^* To whom correspondence should be addressed. E-mail: folsom{at}epi.umn.edu.

Background and Purpose--Numerous case-control and cross-sectional studies have reported higher median lipoprotein(a) [Lp(a)] levels among stroke patients than controls, but existing prospective studies have not consistently shown an association. We sought to examine the relationship between plasma Lp(a) levels and the incidence of ischemic stroke among blacks and whites.

Methods--Between 1987 and 1989, 14 221 men and women (3647 blacks and 10 574 whites) aged 45 to 64 years and free of clinical cardiovascular disease, took part in the first examination of the Atherosclerosis Risk in Communities (ARIC) study cohort. Lp(a) and other risk factors for cardiovascular disease were measured at baseline.

Results--During the 13.5-year follow-up, 496 ischemic strokes occurred. Participants with Lp(a) 300 µg/mL had a 79% higher age, sex, and race-adjusted rate ratio (RR) of ischemic stroke than did those with Lp(a) levels <100 µg/mL. Compared with Lp(a) <100 µg/mL, the multivariate adjusted RRs for Lp(a) 300 µg/mL were 1.84 (95% CI, 1.05 to 3.07) in black women, 1.72 (95% CI, 0.86 to 3.48) in black men, 2.42 (95% CI, 1.30 to 4.53) in white women, and 1.18 (95% CI, 0.47 to 2.90) in white men. There was no significant increment in the RRs for 100 to 199 µg/mL and 200 to 299 µg/mL groups.

Conclusions--A high Lp(a) concentration is associated with a higher incidence of ischemic stroke in blacks and white women, but not in white men.

Key words: brain infarction • epidemiology • lipoprotein • risk factors

Related Article:

Lipoprotein(a): Involved in Events, but Not Burden of Atherosclerotic Disease?

J. David Spence
Stroke 2006 37: 1350-1351. [Full Text] [PDF]

This article has been cited by other articles:

				K.-L. Chien, H.-C. Hsu, T.-C. Su, F.-C. Sung, M.-F. Chen, and Y.-T. Lee Lipoprotein(a) and Cardiovascular Disease in Ethnic Chinese: The Chin-Shan Community Cardiovascular Cohort Study Clin. Chem., February 1, 2008; 54(2): 285 - 291. [Abstract] [Full Text] [PDF]

				E. R. Fox, N. Alnabhan, A. D. Penman, K. R. Butler, H. A. Taylor Jr, T. N. Skelton, and T. H. Mosley Jr Echocardiographic Left Ventricular Mass Index Predicts Incident Stroke in African Americans: Atherosclerosis Risk in Communities (ARIC) Study Stroke, October 1, 2007; 38(10): 2686 - 2691. [Abstract] [Full Text] [PDF]

				B. Smolders, R. Lemmens, and V. Thijs Lipoprotein (a) and Stroke: A Meta-Analysis of Observational Studies Stroke, June 1, 2007; 38(6): 1959 - 1966. [Abstract] [Full Text] [PDF]

				J. D. Spence Lipoprotein(a): Involved in Events, but Not Burden of Atherosclerotic Disease? Stroke, June 1, 2006; 37(6): 1350 - 1351. [Full Text] [PDF]