ArticleArteriosclerosis, thrombosis, and vascular biology2015
Race is a key variable in assigning lipoprotein(a) cutoff values for coronary heart disease risk assessment: the Multi-Ethnic Study of Atherosclerosis.
Open access · bronzeAbstract readComparative StudyMulticenter Study
In one paragraph
Article in Arteriosclerosis, thrombosis, and vascular biology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 111 papers, 4 of them syntheses that pooled it.
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111citing papers in PubMed, 4 pooled it
9.4field-weighted citation impact, top 1% of its field
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Who cites it
111 citing papers in PubMed, 4 syntheses or guidelines pooled it, 203 citations in OpenAlex.
- Predictive value of lipoprotein(a) in coronary artery calcification among asymptomatic cardiovascular disease subjects: A systematic review and meta-analysis.Nutrition, metabolism, and cardiovascular diseases : NMCD · 2023Pooled it
- Association Between Lipoprotein(a) and Calcific Aortic Valve Disease: A Systematic Review and Meta-Analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Association Between Lipoprotein (A) and Diabetic Nephropathy in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis.Frontiers in endocrinology · 2021Pooled it
- The Effects of Tamoxifen on Plasma Lipoprotein(a) Concentrations: Systematic Review and Meta-Analysis.Drugs · 2017Pooled it
- Lipoprotein(a) Lipidome: Responses to Reduced Dietary Saturated Fat Intake in Two Randomized Controlled Feeding Trials.Nutrients · 2025Trial
- Evaluation of Lipoprotein(a) Electrophoretic and Immunoassay Methods in Discriminating Risk of Calcific Aortic Valve Disease and Incident Coronary Heart Disease: The Multi-Ethnic Study of Atherosclerosis.Clinical chemistry · 2017Trial
- Lipoprotein(a)-dependent cardiovascular risk in different populations: are thresholds the same?Annals of medicine · 2026Review
- Letter to the Editor: Prevalence and cardiovascular associations of elevated lipoprotein(a) in people living with HIV: A cross-sectional study.Clinical medicine (London, England) · 2026Article
- Significance of Lipoprotein(a) in Coronary Artery Disease: A Comparative Study of Patients Undergoing Percutaneous Coronary Intervention and Healthy Individuals.Circulation reports · 2026Article
- Lp(a) Has Specific Effects on Coronary Artery Disease Independent of LDL-C: A Mendelian Randomization Study.JACC. Advances · 2026Article
- Association Between Lipoprotein(a) and Cardiac Remodeling Across Race and Ethnicity in the Multi-Ethnic Study of Atherosclerosis.Circulation. Population health and outcomes · 2026Article
- Relationship between lipoprotein(a) and PCSK9 in angiogram-proven premature coronary artery disease in an Asian cohort.Scientific reports · 2026Article
- Lipoprotein(a) in the statin era: from risk marker to therapeutic target.Frontiers in pharmacology · 2026Review
- Lipoprotein(a) Lowering with Pelacarsen (TQJ230).Cardiovascular & hematological disorders drug targets · 2026Review
- A Position Paper on Lipoprotein(a) From the Lipoprotein(a) Task Force of the Korean Society of Lipid and Atherosclerosis: Current Evidence, Clinical Applications, and Future Directions.Korean circulation journal · 2026Review
- The biology of lipoprotein(a): From genetics to molecular mechanisms.European journal of clinical investigation · 2026Review
- A Position Paper on Lipoprotein(a) From the Lipoprotein(a) Task Force of the Korean Society of Lipid and Atherosclerosis: Current Evidence, Clinical Applications, and Future Directions.Journal of lipid and atherosclerosis · 2026Review
- Lipoprotein(a) in Residual Cardiovascular Risk: Measurement Challenges, Assay Standardisation, and Clinical Implications.International journal of general medicine · 2026Review
- Association of Lp(a) With Cardiovascular Disease and All-Cause Mortality in U.S. Hispanics and Latinos.Journal of the American College of Cardiology · 2025Article
- Ancestral Variation in Lp(a): Epidemiology, Isoform Diversity, and Testing.Current atherosclerosis reports · 2025Review
51 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Weihua GuanFrom the Division of Biostatistics, School of Public Health (W.G.) and Department of Laboratory Medicine and Pathology (J.C., B.T.S., M.Y.T.), University of Minnesota, Minneapolis; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle (J.D.K.); and Health Diagnostics Laboratory, Richmond, VA (J.P.M., D.M.H., R.W.).
Jing CaoFrom the Division of Biostatistics, School of Public Health (W.G.) and Department of Laboratory Medicine and Pathology (J.C., B.T.S., M.Y.T.), University of Minnesota, Minneapolis; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle (J.D.K.); and Health Diagnostics Laboratory, Richmond, VA (J.P.M., D.M.H., R.W.).
Brian T SteffenFrom the Division of Biostatistics, School of Public Health (W.G.) and Department of Laboratory Medicine and Pathology (J.C., B.T.S., M.Y.T.), University of Minnesota, Minneapolis; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle (J.D.K.); and Health Diagnostics Laboratory, Richmond, VA (J.P.M., D.M.H., R.W.).
Wendy S PostFrom the Division of Biostatistics, School of Public Health (W.G.) and Department of Laboratory Medicine and Pathology (J.C., B.T.S., M.Y.T.), University of Minnesota, Minneapolis; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle (J.D.K.); and Health Diagnostics Laboratory, Richmond, VA (J.P.M., D.M.H., R.W.).
James H SteinFrom the Division of Biostatistics, School of Public Health (W.G.) and Department of Laboratory Medicine and Pathology (J.C., B.T.S., M.Y.T.), University of Minnesota, Minneapolis; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle (J.D.K.); and Health Diagnostics Laboratory, Richmond, VA (J.P.M., D.M.H., R.W.).
Mathew C TattersallFrom the Division of Biostatistics, School of Public Health (W.G.) and Department of Laboratory Medicine and Pathology (J.C., B.T.S., M.Y.T.), University of Minnesota, Minneapolis; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle (J.D.K.); and Health Diagnostics Laboratory, Richmond, VA (J.P.M., D.M.H., R.W.).
Joel D KaufmanFrom the Division of Biostatistics, School of Public Health (W.G.) and Department of Laboratory Medicine and Pathology (J.C., B.T.S., M.Y.T.), University of Minnesota, Minneapolis; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle (J.D.K.); and Health Diagnostics Laboratory, Richmond, VA (J.P.M., D.M.H., R.W.).
Joseph P McConnellFrom the Division of Biostatistics, School of Public Health (W.G.) and Department of Laboratory Medicine and Pathology (J.C., B.T.S., M.Y.T.), University of Minnesota, Minneapolis; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle (J.D.K.); and Health Diagnostics Laboratory, Richmond, VA (J.P.M., D.M.H., R.W.).
Daniel M HoefnerFrom the Division of Biostatistics, School of Public Health (W.G.) and Department of Laboratory Medicine and Pathology (J.C., B.T.S., M.Y.T.), University of Minnesota, Minneapolis; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle (J.D.K.); and Health Diagnostics Laboratory, Richmond, VA (J.P.M., D.M.H., R.W.).
Russell WarnickFrom the Division of Biostatistics, School of Public Health (W.G.) and Department of Laboratory Medicine and Pathology (J.C., B.T.S., M.Y.T.), University of Minnesota, Minneapolis; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle (J.D.K.); and Health Diagnostics Laboratory, Richmond, VA (J.P.M., D.M.H., R.W.).
Michael Y TsaiFrom the Division of Biostatistics, School of Public Health (W.G.) and Department of Laboratory Medicine and Pathology (J.C., B.T.S., M.Y.T.), University of Minnesota, Minneapolis; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle (J.D.K.); and Health Diagnostics Laboratory, Richmond, VA (J.P.M., D.M.H., R.W.). tsaix001@umn.edu.
University of Washington · USUniversity of Wisconsin–Madison · USJohns Hopkins Medicine · US
Funding
Cigarette Smoke and Susceptibility to Influenza InfectionR01HL095163 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI JASPERS, ILONA, NOAH, TERRY L · 2009 to 2013
$2.0MAdjunctive Use of Apyrase to Fibrinolytic TherapyR44HL095169 · NHLBI · APT THERAPEUTICS, INC. · PI CHEN, RIDONG · 2012 to 2013
$1.3MSUBCLINICAL CARDIOVASCULAR DISEASE STUDYN01HC095166 · HC · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI TRACY, RUSSELL P · 1999 to 2001
$758kSUBCLINICAL CARDIOVASCULAR DISEASE STUDY-FIELD CENTERN01HC095162 · HC · JOHNS HOPKINS UNIVERSITY · PI SZKLO, MOYSES A · 1999 to 2000
$694kSUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095161 · HC · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHEA, STEVEN · 1999 to 2001
$642kSUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095165 · HC · WAKE FOREST UNIVERSITY · PI BURKE, GREGORY L · 1999 to 2001
$616kSUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095160 · HC · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SAAD, MOHAMMED F · 1999 to 2001
$592kSUBCLINICAL CARDIOVASCULAR DISEASE STUDY-FIELD CENTERN01HC095164 · HC · NORTHWESTERN UNIVERSITY · PI LIU, KIANG JOHN · 1999 to 2001
$511kSUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095163 · HC · UNIVERSITY OF MINNESOTA TWIN CITIES · PI FOLSOM, AARON R · 1999 to 2001
$443kEnhancing immune reconstitution after implantation of postnatal allogeneic thymusR21HL095165 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI CROOKS, GAY M · 2008 to 2009
$440kLC-based Nitric Oxide Breath Monitor for Asthma ManagementR43HL095167 · NHLBI · PLATYPUS TECHNOLOGIES, LLC · PI SEN, AVIJIT · 2009 to 2010
$400kSUBCLINICAL CARDIOVASCULAR DISEASE STUDYN01HC095168 · HC · JOHNS HOPKINS UNIVERSITY · PI BLUEMKE, DAVID A. · 1999 to 2000
$375kNHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095160NHLBI NIH HHS N01 HC095161NHLBI NIH HHS N01 HC095162NHLBI NIH HHS N01 HC095163NHLBI NIH HHS N01 HC095164NHLBI NIH HHS N01 HC095165NHLBI NIH HHS N01 HC095166NHLBI NIH HHS N01 HC095167NHLBI NIH HHS N01 HC095168NHLBI NIH HHS N01 HC095169NHLBI NIH HHS N01-HC-95159NHLBI NIH HHS N01-HC-95160NHLBI NIH HHS N01-HC-95161NHLBI NIH HHS N01-HC-95162NHLBI NIH HHS N01-HC-95163NHLBI NIH HHS N01-HC-95164NHLBI NIH HHS N01-HC-95165NHLBI NIH HHS N01-HC-95166NHLBI NIH HHS N01-HC-95167NHLBI NIH HHS N01-HC-95168NHLBI NIH HHS N01-HC-95169
Abstract
objectiveWe aimed to examine associations of lipoprotein(a) (Lp(a)) concentrations with coronary heart disease (CHD) and determine whether current Lp(a) clinical laboratory cut points identify risk of disease incidence in 4 races/ethnicities of the Multi-Ethnic Study of Atherosclerosis (MESA). APPROACH AND
resultsA subcohort of 1323 black, 1677 white, 548 Chinese American, and 1044 Hispanic MESA participants were followed up during a mean 8.5-year period in which 235 incident CHD events were recorded. Lp(a) mass concentrations were measured using a turbidimetric immunoassay. Cox regression analysis determined associations of Lp(a) with CHD risk with adjustments for lipid and nonlipid variables. Lp(a) concentrations were continuously associated with risk of CHD incidence in black (hazard ratio [HR], 1.49; 95% confidence interval [CI], 1.09-2.04] and white participants (HR, 1.22; 95% CI, 1.02-1.45). Examining Lp(a) risk by the 50 mg/dL cut point revealed higher risks of incident CHD in all races except Chinese Americans: blacks (HR, 1.69; 95% CI, 1.03-2.76), whites (HR, 1.82; 95% CI, 1.15-2.88); Hispanics (HR, 2.37; 95% CI, 1.17-4.78). The lower Lp(a) cut point of 30 mg/dL identified higher risk of CHD in black participants alone (HR, 1.87; 95% CI, 1.08-3.21).
conclusionsOur findings suggest that the 30 mg/dL cutoff for Lp(a) is not appropriate in white and Hispanic individuals, and the higher 50 mg/dL cutoff should be considered. In contrast, the 30 mg/dL cutoff remains suitable in black individuals. Further research is necessary to develop the most clinically useful Lp(a) cutoff values in individual races/ethnicities.
Indexed as
Racial GroupsAgedAged, 80 and overAsianBiomarkersBlack or African AmericanChinaCoronary DiseaseDyslipidemiasFemaleHealth Status DisparitiesHispanic or LatinoHumansImmunoassayIncidenceLipoprotein(a)BiomarkersLipoprotein(a)continental population groupscoronary diseaselipoprotein(a)risk factor
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