Lp(a) level, the patients were classified into either a highLp(a) (serum Lp(a) level ≥30 mg/dl) or a low-Lp(a) (serum Lp(a) level <30 mg/dl) group for evaluation of the clinical coronary stenosis progression (CCSP) between the 2 groups. Because a serum Lp(a) level of 31 mg/dl was the 75 th percentile of this study population, we defined patients with a serum Lp(a) level ≥30 mg/dl as the high-Lp(a) group. We also evaluated hypertension (systolic blood pressure >140 mmHg, diastolic blood pressure >90 mmHg or receiv- Background High serum lipoprotein(a) (Lp(a)) levels are associated with coronary artery disease.
Methods and ResultsThe serum Lp(a) levels of 130 patients with acute myocardial infarction (AMI) who underwent direct percutaneous coronary intervention were investigated. On the basis of Lp(a) level at 1 month after the onset of AMI, the patients were classified into 2 groups (high-Lp(a) (≥30 mg/dl) and low-Lp(a) (<30 mg/dl)) for evaluation of the clinical coronary stenosis progression (CCSP) rate. CCSP is defined as either target lesion revascularization (TLR) or new lesion revascularization (NLR). The CCSP rate was significantly higher in the high-Lp(a) group than in the low-Lp(a) group (65.8% vs 29.3%, p<0.01). In patients who had coronary stents in the acute phase (n=79), the CCSP and NLR rates were significantly higher in the high-Lp(a) group than in the low-Lp(a) group (45.0% vs 20.3%, p<0.05; 35.0% vs 6.8%, p<0.01), but there was no significant difference in TLR rate between the 2 groups (10.0% vs 13.6%, p=0.858).Conclusions High serum Lp(a) level is a significant risk factor for CCSP, but does not influence restenosis after stenting. (Circ J 2006; 70: 156 -162)
A 24-year-old woman with Takayasu's disease developed unstable angina pectoris. Angiographic studies demonstrated an isolated left coronary ostial stenosis without any other systemic arterial involvement. She is unique in that the coronary lesion, which is rarely the major manifestation of Takayasu's disease, is the sole arterial involvement of the disease.
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