Plasma Lp(a) levels correlate with number, severity, and length-extension of coronary lesions in male patients undergoing coronary arteriography for clinically suspected coronary atherosclerosis.

Abstract

The relation between lipoprotein(a) [Lp(a)] as an independent risk factor for coronary atherosclerosis and the severity and extension of angiographically detectable coronary atherosclerotic lesions has not been systematically evaluated. In 118 male patients (54.3±7.4 years) with suspected coronary artery disease and without a history of myocardial infarction undergoing coronary angiography, the relation between plasma Lp(a) levels and other lipoproteins and the severity and extension of coronary lesions was studied. The coronary angiograms were evaluated in a blinded manner according to three scores: vessel score (0 to 3 points for 0 to 3 vessels with stenoses a 70%), stenosis score (0 to 32 points; number and severity of coronary stenoses or lesions), and extent score (0 to 100 points; length-extension of all coronary lesions in relation to the total coronary vessel length). The score values obtained

Systemic Inflammatory Parameters in Patients With Atherosclerosis of the Coronary and Peripheral Arteries

“…31,32 In our patients, inflammatory markers were clearly increased in atherosclerotic disease of the coronary and peripheral arteries, even in the absence of unstable angina pectoris (present in only 5% of patients) or myocardial infarction. In previous cross-sectional studies, 4,41 an elevated level of CRP was found to be indicative of "active" CAD manifesting as unstable angina pectoris, plaque rupture, or acute myocardial infarction, whereas in prospective studies, even slight differences in the median CRP levels were found to be predictive of myocardial infarction, stroke, and PAD in men.…”

“…The grade and type of coronary atherosclerosis were scored from the angiographic data retrieved in digital format from CD-ROM by counting the number of affected vessels and by calculating a stenosis score 31,32 as follows. The coronary artery system as displayed in the angiographic movie was first divided into 8 segments: left main stem, left anterior descending artery, diagonal branch, first septal perforator, left circumflex artery, marginal or posterolateral branch, right coronary artery, and main posterior descending branch.…”

“…Scores for each segment were added and therefore the total score could range from 0 to 32 points. 31 …”

The assembly of lipoprotein Lp(a)

“…Despite intensive work in numerous laboratories, the physiological role of Lp(a) remains elusive. Concerning the pathophysiology of Lp(a), there are numerous reports that an elevated plasma concentration of Lp(a) (above 25-30 mg dL ÿ 1 ) is strongly associated with myocardial infarction, peripheral vascular diseases and stroke [5][6][7][8][9][10][11]. In addition, Lp(a) is considered to be a prothrombotic lipoprotein [12].…”

Adenovirus-mediated apo(a)-antisense-RNA expression efficiently inhibits apo(a) synthesis in vitro and in vivo

“…Elevated plasma concentrations above 25-30 mg/dl are considered to contribute to the risk for thrombo-atherogenic diseases. [2][3][4] Lp(a) is a complex plasma lipoprotein formed extracellularly through the covalent binding of free apolipoprotein(a) [apo(a)], being synthesized in the liver, with apoB-100 of low density lipoprotein (LDL). 5 Small amounts of apo(a) are also present in plasma in its free form.…”