Increased stroke risk and lipoprotein(a) in a multiethnic community: The northern manhattan stroke study

Bernadette Boden-Albala, Douglas E. Kargman, I. Feng Lin, Myunghee C. Paik, Ralph L Sacco, Lars Berglund

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Context: Elevated lipoprotein(a) [Lp(a)] is associated with ischemic stroke (IS) among Whites, but data is sparse for non-White populations. Objective: Using a population-based case-control study design with subjects from the Northern Manhattan Stroke Study, we assessed whether Lp(a) levels were independently associated with IS risk among Whites, Blacks and Hispanics. Design and Setting: Lp(a) levels were measured in 317 IS cases (mean age 69 ± 13 years; 56% women; 16% Whites, 31% Blacks and 52% Hispanics) and 413 community-based controls, matched by age, race/ethnicity and gender. In-person assessments included demographics, socioeconomic status, presence of vascular risk factors and fasting lipid levels. Logistic regression was used to determine the independent association of Lp(a) and IS. Stratified analyses investigated gender and race/ethnic differences. Results: Mean Lp(a) levels were greater among cases than controls (46.3 ± 41.0 vs. 38.9 ± 38.2 mg/dl; p < 0.01). After adjusting for stroke risk factors (hypertension, diabetes mellitus, coronary artery disease, cigarette smoking), lipid levels, and socioeconomic status, Lp(a) levels ≥30 mg/dl were independently associated with an increased stroke risk in the overall cohort (adjusted odds ratio, OR, 1.8, 95% confidence interval, CI, 1.20-2.6; p = 0.004). There was a significant linear dose-response relationship between Lp(a) levels and IS risk. The association between IS risk and Lp(a) ≥30 mg/dl was more pronounced among men (adjusted OR 2.0, 95% CI 1.1-3.5; p = 0.02) and among Blacks (adjusted OR 2.7, 95% CI 1.2-6.2; p = 0.02). Conclusion: Elevated Lp(a) levels were significantly and independently associated with increased stroke risk, suggesting that Lp(a) is a risk factor for IS across White, Black and Hispanic race/ethnic groups.

Original languageEnglish
Pages (from-to)237-243
Number of pages7
JournalCerebrovascular Diseases
Volume30
Issue number3
DOIs
StatePublished - Aug 1 2010

Fingerprint

Lipoprotein(a)
Stroke
Hispanic Americans
Social Class
Lipids
Ethnic Groups
Population
Case-Control Studies
Coronary Artery Disease
Fasting
Diabetes Mellitus
Logistic Models
Smoking
Odds Ratio
Demography
Confidence Intervals
Hypertension

Keywords

  • Ischemic stroke
  • Lipoprotein(a)
  • Northern Manhattan Stroke Study

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Increased stroke risk and lipoprotein(a) in a multiethnic community : The northern manhattan stroke study. / Boden-Albala, Bernadette; Kargman, Douglas E.; Lin, I. Feng; Paik, Myunghee C.; Sacco, Ralph L; Berglund, Lars.

In: Cerebrovascular Diseases, Vol. 30, No. 3, 01.08.2010, p. 237-243.

Research output: Contribution to journalArticle

Boden-Albala, Bernadette ; Kargman, Douglas E. ; Lin, I. Feng ; Paik, Myunghee C. ; Sacco, Ralph L ; Berglund, Lars. / Increased stroke risk and lipoprotein(a) in a multiethnic community : The northern manhattan stroke study. In: Cerebrovascular Diseases. 2010 ; Vol. 30, No. 3. pp. 237-243.
@article{a32e4a8d9f5743f08f3e6e9bfb852f4c,
title = "Increased stroke risk and lipoprotein(a) in a multiethnic community: The northern manhattan stroke study",
abstract = "Context: Elevated lipoprotein(a) [Lp(a)] is associated with ischemic stroke (IS) among Whites, but data is sparse for non-White populations. Objective: Using a population-based case-control study design with subjects from the Northern Manhattan Stroke Study, we assessed whether Lp(a) levels were independently associated with IS risk among Whites, Blacks and Hispanics. Design and Setting: Lp(a) levels were measured in 317 IS cases (mean age 69 ± 13 years; 56{\%} women; 16{\%} Whites, 31{\%} Blacks and 52{\%} Hispanics) and 413 community-based controls, matched by age, race/ethnicity and gender. In-person assessments included demographics, socioeconomic status, presence of vascular risk factors and fasting lipid levels. Logistic regression was used to determine the independent association of Lp(a) and IS. Stratified analyses investigated gender and race/ethnic differences. Results: Mean Lp(a) levels were greater among cases than controls (46.3 ± 41.0 vs. 38.9 ± 38.2 mg/dl; p < 0.01). After adjusting for stroke risk factors (hypertension, diabetes mellitus, coronary artery disease, cigarette smoking), lipid levels, and socioeconomic status, Lp(a) levels ≥30 mg/dl were independently associated with an increased stroke risk in the overall cohort (adjusted odds ratio, OR, 1.8, 95{\%} confidence interval, CI, 1.20-2.6; p = 0.004). There was a significant linear dose-response relationship between Lp(a) levels and IS risk. The association between IS risk and Lp(a) ≥30 mg/dl was more pronounced among men (adjusted OR 2.0, 95{\%} CI 1.1-3.5; p = 0.02) and among Blacks (adjusted OR 2.7, 95{\%} CI 1.2-6.2; p = 0.02). Conclusion: Elevated Lp(a) levels were significantly and independently associated with increased stroke risk, suggesting that Lp(a) is a risk factor for IS across White, Black and Hispanic race/ethnic groups.",
keywords = "Ischemic stroke, Lipoprotein(a), Northern Manhattan Stroke Study",
author = "Bernadette Boden-Albala and Kargman, {Douglas E.} and Lin, {I. Feng} and Paik, {Myunghee C.} and Sacco, {Ralph L} and Lars Berglund",
year = "2010",
month = "8",
day = "1",
doi = "10.1159/000319065",
language = "English",
volume = "30",
pages = "237--243",
journal = "Cerebrovascular Diseases",
issn = "1015-9770",
publisher = "S. Karger AG",
number = "3",

}

TY - JOUR

T1 - Increased stroke risk and lipoprotein(a) in a multiethnic community

T2 - The northern manhattan stroke study

AU - Boden-Albala, Bernadette

AU - Kargman, Douglas E.

AU - Lin, I. Feng

AU - Paik, Myunghee C.

AU - Sacco, Ralph L

AU - Berglund, Lars

PY - 2010/8/1

Y1 - 2010/8/1

N2 - Context: Elevated lipoprotein(a) [Lp(a)] is associated with ischemic stroke (IS) among Whites, but data is sparse for non-White populations. Objective: Using a population-based case-control study design with subjects from the Northern Manhattan Stroke Study, we assessed whether Lp(a) levels were independently associated with IS risk among Whites, Blacks and Hispanics. Design and Setting: Lp(a) levels were measured in 317 IS cases (mean age 69 ± 13 years; 56% women; 16% Whites, 31% Blacks and 52% Hispanics) and 413 community-based controls, matched by age, race/ethnicity and gender. In-person assessments included demographics, socioeconomic status, presence of vascular risk factors and fasting lipid levels. Logistic regression was used to determine the independent association of Lp(a) and IS. Stratified analyses investigated gender and race/ethnic differences. Results: Mean Lp(a) levels were greater among cases than controls (46.3 ± 41.0 vs. 38.9 ± 38.2 mg/dl; p < 0.01). After adjusting for stroke risk factors (hypertension, diabetes mellitus, coronary artery disease, cigarette smoking), lipid levels, and socioeconomic status, Lp(a) levels ≥30 mg/dl were independently associated with an increased stroke risk in the overall cohort (adjusted odds ratio, OR, 1.8, 95% confidence interval, CI, 1.20-2.6; p = 0.004). There was a significant linear dose-response relationship between Lp(a) levels and IS risk. The association between IS risk and Lp(a) ≥30 mg/dl was more pronounced among men (adjusted OR 2.0, 95% CI 1.1-3.5; p = 0.02) and among Blacks (adjusted OR 2.7, 95% CI 1.2-6.2; p = 0.02). Conclusion: Elevated Lp(a) levels were significantly and independently associated with increased stroke risk, suggesting that Lp(a) is a risk factor for IS across White, Black and Hispanic race/ethnic groups.

AB - Context: Elevated lipoprotein(a) [Lp(a)] is associated with ischemic stroke (IS) among Whites, but data is sparse for non-White populations. Objective: Using a population-based case-control study design with subjects from the Northern Manhattan Stroke Study, we assessed whether Lp(a) levels were independently associated with IS risk among Whites, Blacks and Hispanics. Design and Setting: Lp(a) levels were measured in 317 IS cases (mean age 69 ± 13 years; 56% women; 16% Whites, 31% Blacks and 52% Hispanics) and 413 community-based controls, matched by age, race/ethnicity and gender. In-person assessments included demographics, socioeconomic status, presence of vascular risk factors and fasting lipid levels. Logistic regression was used to determine the independent association of Lp(a) and IS. Stratified analyses investigated gender and race/ethnic differences. Results: Mean Lp(a) levels were greater among cases than controls (46.3 ± 41.0 vs. 38.9 ± 38.2 mg/dl; p < 0.01). After adjusting for stroke risk factors (hypertension, diabetes mellitus, coronary artery disease, cigarette smoking), lipid levels, and socioeconomic status, Lp(a) levels ≥30 mg/dl were independently associated with an increased stroke risk in the overall cohort (adjusted odds ratio, OR, 1.8, 95% confidence interval, CI, 1.20-2.6; p = 0.004). There was a significant linear dose-response relationship between Lp(a) levels and IS risk. The association between IS risk and Lp(a) ≥30 mg/dl was more pronounced among men (adjusted OR 2.0, 95% CI 1.1-3.5; p = 0.02) and among Blacks (adjusted OR 2.7, 95% CI 1.2-6.2; p = 0.02). Conclusion: Elevated Lp(a) levels were significantly and independently associated with increased stroke risk, suggesting that Lp(a) is a risk factor for IS across White, Black and Hispanic race/ethnic groups.

KW - Ischemic stroke

KW - Lipoprotein(a)

KW - Northern Manhattan Stroke Study

UR - http://www.scopus.com/inward/record.url?scp=77954884216&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77954884216&partnerID=8YFLogxK

U2 - 10.1159/000319065

DO - 10.1159/000319065

M3 - Article

C2 - 20664256

AN - SCOPUS:77954884216

VL - 30

SP - 237

EP - 243

JO - Cerebrovascular Diseases

JF - Cerebrovascular Diseases

SN - 1015-9770

IS - 3

ER -