Background and aim: Most but not all studies in children, adolescents and young adults with a family history of coronary artery disease have reported an increase in lipoprotein(a) (Lp(a)) concentrations. The aim of this study was to assess if healthy children, adolescents and young adults with a parental history of premature myocardial infarction (PHPMI) have increased Lp(a) levels and are at higher risk of elevated (>30 mg/dl) Lp(a) concentrations.
Methods and results: One hundred fifty healthy children, adolescents and young adults with PHPMI (55% males; age 18+/-6.7 years) and 150 age- (+/-1 year) and gender-matched control subjects participated in the study. Concentrations of total plasma cholesterol, low-density lipoprotein (LDL)-cholesterol, high density lipoprotein (HDL)-cholesterol, apolipoprotein (Apo) A-I and B, triglycerides and Lp(a) were determined after fasting for 14 h. Participants with PHPMI had higher concentrations of LDL-cholesterol (107.9+/-31.1 vs. 99.2+/-28.7 mg/dl, p=0.01), Apo B (89.6+/-26.4 vs. 82.8+/-20.2 mg/dl, p=0.011) and Lp(a) (26.7+/-34.0 vs. 19.2+/-23.2 mg/dl, p=0.012) and lower HDL-cholesterol concentrations (47.9+/-11.3 vs. 50.7+/-13.9 mg/dl, p=0.038) than participants without PHPMI. Thirty percent of PHPMI positive subjects had elevated Lp(a) concentrations vs. 16.7% of PHPMI negative subjects (p=0.009; relative risk 2.14; 95% CI 1.23-3.73). In a conditional logistic regression analysis, Lp(a) concentration was significantly and independently associated with PHPMI.
Conclusions: Healthy young subjects with PHPMI have increased Lp(a) levels, a higher risk for elevated Lp(a) concentrations within an unfavourable lipid profile.