Comparison of Lipoprotein(a) levels between elderly and middle-aged men with coronary artery disease.

Lipoprotein(a) [Lp(a)] is known to be a risk factor for atherosclerotic disease in middle-aged men, but the role of Lp(a) in women and in the elderly is less clear. In most studies, excess Lp(a) is not associated with increased risk for persons >65 years of age. This study examined the strength of association of a number of risk factors to coronary artery disease (CAD) in groups of men <65 years (n = 108) and >65 of age (n = 66) with angiographically documented significant narrowing of coronary arteries. Serum Lp(a) concentrations were determined; elevated Lp(a) is positively associated with CAD for men <65 years (adjusted OR: 2.45, P <0.05) but not for men >65 of age (adjusted OR: 0.56, P = NS). For middle-aged men, elevated Lp(a) appears to be an independent risk factor for premature CAD, and the importance of Lp(a) as a risk factor appears to decrease with age. These data suggest that the utility of Lp(a) lipoprotein levels in predicting the risk of CAD in older men is limited. Factors, such as age; sex; levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides; carotid-wall thickness; smoking status; the presence or absence of diabetes and systolic and diastolic hypertension; body mass index (BMI); and other traditional risk factors, must be evaluated together to determine the risk of CAD for the entire population.