LIPOPROTEIN (A) LEVELS PREDICT PULSE WAVE VELOCITY IN SUBJECTS IN PRIMARY PREVENTION FOR CARDIOVASCULAR DISEASE WITH LARGE APO(A) ISOFORMS: DATA FROM THE BRISIGHELLA HEART STUDY

Abstract

Objective: In the last decades, high serum levels of lipoprotein(a) (Lp(a)) have been associated with increased cardiovascular disease (CVD) risk, in particular among individuals with smaller apolipoprotein(a) (apo(a)) isoforms than those with larger sizes. The aim of our analysis was to evaluate whether Lp(a) levels could predict early vascular aging, and whether smaller apo(a) isoforms have a predictive value of vascular aging different than larger apo(a) isoforms in a cohort of subjects free from CVD. Design and method: We considered the data of a subset of Brisighella Heart Study (BHS) participants free from CVD (462 men and 516 women) who were clinically evaluated during the 2012 BHS population survey. Predictors of arterial stiffness -measured as carotid-femoral pulse wave velocity (cf-PWV)- were estimated by the application of a step-wise linear regression model. Results: In our cohort, there were 511 subjects with small apo(a) size and 467 subjects with large apo(a) isoforms. Subjects with larger apo(a) isoform sizes had significantly lower serum levels of Lp(a). In the BHS subpopulation sample, cfPWV was predicted by age, systolic blood pressure (SBP), serum levels of high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and sex, being higher HDL-C serum levels and female sex associated to lower values of cfPWV. In subjects with smaller apo(a) isoform sizes, predictors of cf-PWV were age, SBP, sex and serum levels of HDL-C, being higher HDL-C serum levels and female sex associated to lower values of cfPWV. In subjects with larger apo(a) isoform sizes, cf-PWV was predicted by age, SBP, serum levels of Lp(a) and sex, being female sex associated to lower values of cfPWV. Conclusions: In our subpopulation sample, Lp(a) did not predict cfPWV. However, among subjects with larger apo(a) isoform sizes Lp(a) was a significant predictor of arterial stiffness.