Financiado en parte por AstraZeneca, GlaxoSmithKline, Bupa Foundation, Merck Sharp and Dohme
Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality
Emerging Risk Factors Collaboration, Erqou S, Kaptoge S, Perry PL, Di Angelantonio E, Thompson A, White IR, Marcovina SM, Collins R, Thompson SG, Danesh J
JAMA · 1,354 citas
Etiquetas de revisión
Financiado por la industriaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiado por la industria
- Empresa
- AstraZeneca
- Empresa
- GlaxoSmithKline
- Organización sin fines de lucro
- Wellcome Trust
- Organización sin fines de lucro
- British Heart Foundation
- Empresa
- Bupa Foundation
- Gobierno
- European Commission
- Organización sin fines de lucro
- Evelyn Trust
- Empresa
- Merck Sharp and Dohme
- Gobierno
- Medical Research Council
- Gobierno
- Economic and Social Research Council
- Gobierno
- National Institute on Aging
- Gobierno
- NIA NIH HHS
- Subvenciones
- National Institute on Aging (R03AG021162); Economic and Social Research Council (ES/G007438/1); British Heart Foundation (RG/08/014); British Heart Foundation (RG/07/008/23674); British Heart Foundation (RG/08/014/24067)
Según 12 financiadores declarados.
Publicación
- Publicado
- 2009-07-21 · JAMA · vol. 302 · número 4 · pág. 412
- Editorial
- American Medical Association
- Citado
- 1,746 citas · más que el 100% de estudios similares · 70.1× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 105 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Atherosclerosis and Cardiovascular Diseases · Diabetes, Cardiovascular Risks, and Lipoproteins
- Palabras clave
- lipoprotein(a), coronary artery disease, stroke, vascular disease, cardiovascular risk factors, low-density lipoprotein, triglycerides, HDL cholesterol, HDL2, HDL3, prospective cohort, meta-analysis, cardiovascular risk prediction, cardiovascular disease treatment
- MeSH
- humans, coronary disease, lipoprotein(a), cause of death, risk factors, stroke
1 autor
- The Emerging Risk Factors Collaboration*🇬🇧 · autor de correspondenciaUniversity of Cambridge
Resumen
El texto original del estudio, en el idioma en que se publicó.
Context
Circulating concentration of lipoprotein(a) (Lp[a]), a large glycoprotein attached to a low-density lipoprotein-like particle, may be associated with risk of coronary heart disease (CHD) and stroke.
Objective
To assess the relationship of Lp(a) concentration with risk of major vascular and nonvascular outcomes.
Study selection
Long-term prospective studies that recorded Lp(a) concentration and subsequent major vascular morbidity and/or cause-specific mortality published between January 1970 and March 2009 were identified through electronic searches of MEDLINE and other databases, manual searches of reference lists, and discussion with collaborators.
Data extraction
Individual records were provided for each of 126,634 participants in 36 prospective studies. During 1.3 million person-years of follow-up, 22,076 first-ever fatal or nonfatal vascular disease outcomes or nonvascular deaths were recorded, including 9336 CHD outcomes, 1903 ischemic strokes, 338 hemorrhagic strokes, 751 unclassified strokes, 1091 other vascular deaths, 8114 nonvascular deaths, and 242 deaths of unknown cause. Within-study regression analyses were adjusted for within-person variation and combined using meta-analysis. Analyses excluded participants with known preexisting CHD or stroke at baseline.
Data synthesis
Lipoprotein(a) concentration was weakly correlated with several conventional vascular risk factors and it was highly consistent within individuals over several years. Associations of Lp(a) with CHD risk were broadly continuous in shape. In the 24 cohort studies, the rates of CHD in the top and bottom thirds of baseline Lp(a) distributions, respectively, were 5.6 (95% confidence interval [CI], 5.4-5.9) per 1000 person-years and 4.4 (95% CI, 4.2-4.6) per 1000 person-years. The risk ratio for CHD, adjusted for age and sex only, was 1.16 (95% CI, 1.11-1.22) per 3.5-fold higher usual Lp(a) concentration (ie, per 1 SD), and it was 1.13 (95% CI, 1.09-1.18) following further adjustment for lipids and other conventional risk factors. The corresponding adjusted risk ratios were 1.10 (95% CI, 1.02-1.18) for ischemic stroke, 1.01 (95% CI, 0.98-1.05) for the aggregate of nonvascular mortality, 1.00 (95% CI, 0.97-1.04) for cancer deaths, and 1.00 (95% CI, 0.95-1.06) for nonvascular deaths other than cancer.
Conclusion
Under a wide range of circumstances, there are continuous, independent, and modest associations of Lp(a) concentration with risk of CHD and stroke that appear exclusive to vascular outcomes.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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