Lipoprotein Lp(a). A risk factor for myocardial infarction.

The aim of this study was to test plasma lipoprotein Lp(a) and other lipid and lipoprotein levels for association with the incidence of myocardial infarction. Total plasma cholesterol, triglycerides, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and Lp(a) were measured in 1486 men at the age of 18 years. In addition, the Broca Index (a measure of relative body weight) and other data were recorded. The sample was divided into probands whose mothers or fathers suffered a myocardial infarction (case group, n = 52) and into probands whose parents had no myocardial infarction (control group, n = 1434). In the case group, 32% had Lp(a) plasma concentrations greater than 25 mg/dl, but only 13.4% of the control group had this level of concentration, a highly significant difference (p less than 0.01). In addition, there was a statistically significant difference in the ratio of LDL cholesterol/HDL cholesterol (p less than 0.05) and the Broca Index (p less than 0.01) between cases and controls. The parents of the case group were significantly older than the parents of the control group; however, when a control group was matched for parents' age, the results were similar. These data suggest that parents of male children with Lp(a) plasma concentrations greater than 25 mg/dl have a 2.5-fold higher incidence of myocardial infarction. Considering the familial aggregation of elevated Lp(a) levels, we conclude that increased levels of this lipoprotein may be a significant risk factor for myocardial infarction.