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Contracts","award":["75N92020D00002"],"award-info":[{"award-number":["75N92020D00002"]}]},{"name":"National Institutes of Health under Contracts","award":["N01-HC-95161"],"award-info":[{"award-number":["N01-HC-95161"]}]},{"name":"National Institutes of Health under Contracts","award":["75N92020D00003"],"award-info":[{"award-number":["75N92020D00003"]}]},{"name":"National Institutes of Health under Contracts","award":["N01-HC-95162"],"award-info":[{"award-number":["N01-HC-95162"]}]},{"name":"National Institutes of Health under Contracts","award":["75N92020D00006"],"award-info":[{"award-number":["75N92020D00006"]}]},{"name":"National Institutes of Health under Contracts","award":["N01-HC-95163"],"award-info":[{"award-number":["N01-HC-95163"]}]},{"name":"National Institutes of Health under Contracts","award":["75N92020D00004"],"award-info":[{"award-number":["75N92020D00004"]}]},{"name":"National Institutes of Health under Contracts","award":["N01-HC-95164"],"award-info":[{"award-number":["N01-HC-95164"]}]},{"name":"National Institutes of Health under Contracts","award":["75N92020D00007"],"award-info":[{"award-number":["75N92020D00007"]}]},{"name":"National Institutes of Health under Contracts","award":["N01-HC-95165"],"award-info":[{"award-number":["N01-HC-95165"]}]},{"name":"National Institutes of Health under Contracts","award":["N01-HC-95166"],"award-info":[{"award-number":["N01-HC-95166"]}]},{"name":"National Institutes of Health under Contracts","award":["N01-HC-95167"],"award-info":[{"award-number":["N01-HC-95167"]}]},{"name":"National Institutes of Health under Contracts","award":["N01-HC-95168"],"award-info":[{"award-number":["N01-HC-95168"]}]},{"name":"National Institutes of Health under Contracts","award":["N01-HC-95169"],"award-info":[{"award-number":["N01-HC-95169"]}]},{"name":"National Institutes of Health under Contracts","award":["UL1-TR-000040"],"award-info":[{"award-number":["UL1-TR-000040"]}]},{"name":"National Institutes of Health under Contracts","award":["UL1-TR-001079"],"award-info":[{"award-number":["UL1-TR-001079"]}]},{"name":"National Institutes of Health under Contracts","award":["UL1-TR-001420"],"award-info":[{"award-number":["UL1-TR-001420"]}]},{"name":"National Institutes of Health under Contracts","award":["UL1-TR-000040"],"award-info":[{"award-number":["UL1-TR-000040"]}]},{"name":"National Institutes of Health under Contracts","award":["UL1-TR-001079"],"award-info":[{"award-number":["UL1-TR-001079"]}]},{"name":"National Institutes of Health under Contracts","award":["UL1-TR-001420"],"award-info":[{"award-number":["UL1-TR-001420"]}]},{"name":"National Institutes of Health under Contracts","award":["NHLBI N01-HC 25195"],"award-info":[{"award-number":["NHLBI N01-HC 25195"]}]},{"name":"National Institutes of Health under Contracts","award":["HHSN268201500001I"],"award-info":[{"award-number":["HHSN268201500001I"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Elevated lipoprotein(a) [Lp(a)] is associated with increased incidence of atherosclerotic cardiovascular disease (ASCVD). We aimed to assess the utility of Lp(a) as an ASCVD risk-enhancing factor, as recommended by the 2019 ACC\/AHA guidelines on ASCVD primary prevention, and to determine whether C-reactive protein (CRP) modifies the association of elevated Lp(a) with ASCVD risk. Methods: Lp(a), high sensitivity CRP (hs-CRP), and other ASCVD risk factors, including blood lipids, blood pressure, diabetes status, body weight and height, and smoking, were measured in 15,933 participants (median age 61.7 years with 25th\u201375th percentiles 57\u201368 years, 56.7% female, 19.7% Black, free of ASCVD at baseline) in the Atherosclerosis Risk in Communities Study, Framingham Offspring Study, and Multi-Ethnic Study of Atherosclerosis. Participants were followed for 10 years for incident ASCVD (coronary heart disease (CHD) or stroke) and CHD (including angioplasty and\/or coronary artery bypass but minus stroke). These endpoints occurred in 9.7% and 7.4% of subjects, respectively. Results: Compared with the lowest Lp(a) category (&lt;10 mg\/dL), the highest Lp(a) category (\u226550 mg\/dL) carried a significantly increased incidence of ASCVD (hazard ratio [HR] = 1.31; 95% confidence interval [CI] 1.15\u20131.50; p &lt; 0.001) and CHD (HR = 1.49; 95%CI 1.27\u20131.75; p &lt; 0.001). The association of elevated Lp(a) with incident ASCVD was stronger in males and non-Black individuals and was independent of diabetes status. Lp(a) levels \u2265 50 mg\/dL predicted the 10-year ASCVD risk for those at intermediate risk (\u22657.5%, HR = 1.32; 95%CI 1.15\u20131.52; p &lt; 0.001). There was a significant interaction between Lp(a) and hs-CRP; individuals with concomitant elevated levels of Lp(a) and hs-CRP had the highest ASCVD risk. Conclusions: Elevated Lp(a) levels were associated with increased ASCVD risk, particularly in individuals with concomitantly elevated hs-CRP levels and those at intermediate 10-year ASCVD risk.<\/jats:p>","DOI":"10.3390\/nu17081324","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T03:45:23Z","timestamp":1744343123000},"page":"1324","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Lipoprotein(a) and Risk of Incident Atherosclerotic Cardiovascular Disease: Impact of High-Sensitivity C-Reactive Protein and Risk Variability Among Human Clinical Subgroups"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2399-4653","authenticated-orcid":false,"given":"Ron C.","family":"Hoogeveen","sequence":"first","affiliation":[{"name":"Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret R.","family":"Diffenderfer","sequence":"additional","affiliation":[{"name":"Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA"},{"name":"Boston Heart Diagnostics, Framingham, MA 01702, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA"},{"name":"The Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, MA 01702, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0703-0742","authenticated-orcid":false,"given":"Ching-Ti","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA"},{"name":"The Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, MA 01702, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6677-6341","authenticated-orcid":false,"given":"Hiroaki","family":"Ikezaki","sequence":"additional","affiliation":[{"name":"Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA"},{"name":"Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0956-9821","authenticated-orcid":false,"given":"Weihua","family":"Guan","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN 55414, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Y.","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN 55455, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christie M.","family":"Ballantyne","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA"},{"name":"Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA"},{"name":"Center for Cardiovascular Disease Prevention, Debakey Heart and Vascular Disease Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1126\/science.2530631","article-title":"The mysteries of lipoprotein(a)","volume":"246","author":"Utermann","year":"1989","journal-title":"Science"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2331","DOI":"10.1001\/jama.2009.801","article-title":"Genetically elevated lipoprotein(a) and increased risk of myocardial infarction","volume":"301","author":"Kamstrup","year":"2009","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2518","DOI":"10.1056\/NEJMoa0902604","article-title":"Genetic variants associated with Lp(a) lipoprotein level and coronary disease","volume":"361","author":"Clarke","year":"2009","journal-title":"N. 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