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(Stroke. 2006;37:1407.)
© 2006 American Heart Association, Inc.

Original Contributions

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 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.

Correspondence and reprint requests to Aaron R. Folsom, MD, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454-1015. 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

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

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