Lipoprotein(a) and abdominal aortic aneurysm risk: The Atherosclerosis Risk in Communities study

Yasuhiko Kubota, Aaron R. Folsom, Christie M. Ballantyne, Weihong Tang

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background and aims No prospective study has investigated whether elevated lipoprotein(a) concentrations are associated with an increased risk of abdominal aortic aneurysm (AAA). We aimed to prospectively investigate this association. Methods In 1987–1989, the Atherosclerosis Risk in Communities study measured plasma lipoprotein(a) in 13,683 participants aged 45–64 years, without a history of AAA surgery. We followed them for incident, clinical AAA events through 2011. Results During the 272,914 person-years of follow-up, over a median of 22.6 years, we documented 505 incident AAA events. The age-, sex-, and race-adjusted model showed that individuals in the highest quintile of plasma lipoprotein(a) had an increased risk of AAA. Further adjustment for the other potential confounding factors, including other plasma lipids (high- and low-density lipoprotein cholesterol and triglyceride concentrations), attenuated the association, but individuals in the highest versus lowest quintile of plasma lipoprotein(a) still had a significantly increased risk of AAA [hazard ratio (95% confidence interval): 1.57 (1.19–2.08)]. Interaction testing suggested no difference in the associations for whites and African Americans (p for interaction = 0.96). A restricted cubic spline analysis demonstrated a positive dose-response relation of plasma lipoprotein(a) with AAA, with a steep increase in AAA risk above the 75th percentile (p for overall association = 0.0086, p for non-linear association = 0.097). Conclusions In this population-based cohort study, elevated lipoprotein(a) concentrations were independently associated with an increased risk of AAA. The association reflected a threshold of increased AAA risk at high lipoprotein(a) concentrations, rather than a steady monotonic association.

Original languageEnglish (US)
Pages (from-to)63-67
Number of pages5
JournalAtherosclerosis
Volume268
DOIs
StatePublished - Jan 2018

Bibliographical note

Funding Information:
The Nippon Foundation provided grants to support Dr. Kubota's fellowship at School of Public Health, University of Minnesota. The National Heart, Lung, and Blood Institute (NHLBI) supported ARIC via contracts HHSN268201100005C , HHSN268201100006C , HHSN268201100007C , HHSN268201100008C , HHSN268201100009C , HHSN268201100010C , HHSN268201100011C , HHSN268201100012C , and the collection of AAA data via R01 HL103695 .

Funding Information:
The Nippon Foundation provided grants to support Dr. Kubota's fellowship at School of Public Health, University of Minnesota. The National Heart, Lung, and Blood Institute (NHLBI) supported ARIC via contracts HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, HHSN268201100012C, and the collection of AAA data via R01 HL103695.

Keywords

  • Abdominal aortic aneurysm
  • Lipoprotein(a)
  • Population-based study
  • Prospective study

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