Cardiovascular Disease, Mortality Risk, and Healthcare Costs by Lipoprotein(a) Levels According to Low‐density Lipoprotein Cholesterol Levels in Older High‐risk Adults

摘要

Background The value of lipoprotein(a) (Lp[a]) for predicting cardiovascular disease (CVD) across low-density lipoprotein cholesterol (LDL-C) is uncertain. Hypothesis In older high-risk adults, higher LDL and Lp(a) combined would be associated with higher CVD risk and more healthcare costs. Methods We included 3251 high-risk subjects (prior CVD, diabetes, or 10-year Framingham CVD risk >20%) age ≥65 years from the Cardiovascular Health Study and examined the relation of Lp(a) tertiles with incident CVD, coronary heart disease (CHD), and all-cause mortality within LDL-C strata (spanning Results Over a 22.5-year follow-up, higher Lp(a) levels predicted CVD and total mortality (both standardized hazard ratio [HR]: 1.06, P Conclusions In older high-risk adults, increased Lp(a) levels were associated with higher CVD risk, especially in those with LDL-C