Gender Differences in
Plasma Levels of Lipoprotein (a) in Patients with
Angiographically Proven Coronary Artery Disease
J. FROHLICH1, M. DOBIÁŠOVÁ2, L. ADLER1,
M. FRANCIS1
1Department of Pathology and Laboratory Medicine,
University of British Columbia,
Healthy Heart Program/Lipid Clinic, St. Paul’s Hospital,
Vancouver B.C., Canada,
2Institute of Physiology, Academy of Sciences of the
Czech Republic, Prague, Czech Republic
Received July 22, 2003
Accepted November 6, 2003
Summary
The objective of the study was to assess the association between
plasma levels of lipoprotein(a) [Lp(a)] and the presence of
angiographically defined coronary artery disease (aCAD).
Patients (346 men and 184 women) undergoing selective coronary
angiography (SCA) were classified into groups with positive
[aCAD(+)] and negative [aCAD(–)] findings and their age, body
mass index (BMI), waist circumference, blood pressure, smoking,
plasma total, LDL-, HDL-cholesterol (TC, LDL-C, HDL-C),
triglycerides (TG), apolipoprotein B (apoB), Log(TG/HDL-C) and
TC/HDL-C were determined. Concentration of plasma Lp(a) was
estimated using the commercial solid phase two-side
immunoradiometric assay of apolipoprotein apo(a). The plasma
Lp(a) was significantly higher in both women and men with
aCAD(+) compared to those with aCAD(–). While there was no
significant difference in the Lp(a) level between men and women
with aCAD(–) (median 138 vs. 145 units/l), the women with
aCAD(+) had almost twice as high Lp(a) levels as men (median 442
vs. 274 units/l, p<0.001). Women with aCAD(+) had also
significantly lower HDL cholesterol levels (1.09 vs. 1.20
mmol/l, p<0.05), higher triglycerides (1.82 vs. 1.46 mmol/l,
p<0.05) and Log(TG/HDL-C) than women with aCAD(–). The
differences in Lp(a) between positive and negative findings
remained highly significant (p<0.001 in women, p<0.05 in men)
after the adjustment for age, plasma HDL- and LDL-cholesterol
and triglycerides in logistic regression analyses. In logistic
regression model the Lp(a) and Log(TG/HDL-C) and smoking in
women but smoking and age in men were the most powerful
predictors of positive aCAD findings. Our findings suggest that
Lp(a) is more strongly associated with aCAD+ in women than in
men.
Key words
Lipoprotein(a) • Gender • Coronary artery disease • Coronary
angiography • Immunoradiometric assay
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