Serum lipoprotein(a) concentrations are related to coronary disease progression without new myocardial infarction.

Abstract

Objective-To examine the association between serum lipoprotein(a) and angiographically assessed coronary artery disease progression without new myocardial infarction. Patients and design-85 patients with coronary artery disease who underwent serial angiography with an interval of at least two years were studied. Progression of coronary artery disease was defined as an increase in diameter stenosis of 15% or more. Vessels on which angioplasty had been performed were excluded from the analysis. The patients were classified into two groups: a progression group without new myocardial infarction (n = 48) and non-progression group (n = 37). Risk factors including lipoprotein(a) were evaluated to see how they were related to progression without myocardial infarction. Results-There were no differences between the two groups in the following factors: age, gender, the time interval between the angiographic studies, the distribution of the analysed coronary arteries, and history of well established coronary risk factors. Univariate analysis showed that serum lipoprotein(a) (P = 0'0002), cigarette smoking between the studies (P = 0.002), serum high density lipoprotein (P = 0.003), and serum low density lipoprotein (P = 0*01) were related to progression without myocardial infarction. Multivariate analysis selected two independent factors for progression without myocardial infarction: serum lipoprotein(a) (P = 0.003) and serum high density lipoprotein (P = 0.03).Conclusions-Serum lipoprotein(a) concentrations are closely related to the progression of coronary artery disease without new myocardial infarction. Lipoprotein(a) lowering treatment may be needed to prevent disease progression in patients with coronary artery disease and high serum lipoprotein(a). (Br Heart_J 1995;74:365-369)

Relation Between Lipoprotein(a) and Fibrinogen and Serial Intravascular Ultrasound Plaque Progression in Left Main Coronary Arteries

“…However, other studies failed to demonstrate an association between Lp(a) and cardiovascular disease (29,30). In good agreement with our findings, Lp(a) levels showed a strong correlation with serial plaque progression assessed in previous angiographic (17)(18)(19)(20) and electron beam tomographic studies (21). Uchida et al (18) showed Lp(a) to be an independent predictor of angiographic lesion progression at 6 months follow-up, and Matsumoto et al (19) showed that the Lp(a) level was significantly associated with angiographic disease progression after more than 24 months.…”

“…There is evidence that plaque progression in coronary arteries is linked to a higher risk of future fatal or nonfatal cardiovascular events (15,16). Lipoprotein(a) is associated with plaque progression, as indirectly assessed by lumen changes in short-term (17,18) and long-term (19,20) angiographic follow-up, and with calcium score changes as measured by sequential electron beam computerized tomography (21). There are no data demonstrating directly the relation between Lp(a), fibrinogen, and coronary plaque progression.…”

Serum lipoprotein(a) level in relation to severity of coronary artery disease and coronary artery patency in acute myocardial infarction

“…This is in agreement with previous angiographic studies suggesting that Lp(a) may be a risk factor for coronary artery disease. [7][8][9][10][11][12][13][14] The reason for the divergent results of Çömlekçi et al 15 is not known. The overall changes in the coronary and infarct artery scores during follow-up were not statistically significant, probably due to the short follow-up and modification of risk factors after infarction, as also indicated by the decrease in total cholesterol and LDL cholesterol levels.…”

“…The overall changes in the coronary and infarct artery scores during follow-up were not statistically significant, probably due to the short follow-up and modification of risk factors after infarction, as also indicated by the decrease in total cholesterol and LDL cholesterol levels. Previous studies have shown that a high serum Lp(a) level is related to angiographic progression of coronary artery disease in patients without MI 11,12 but further studies in larger patient populations and with longer follow-up times are needed to clarify the role of Lp(a) in the progression of coronary artery disease immediately after MI.…”

Serum Lipoprotein(a) Level and Clinical Coronary Stenosis Progression in Patients With Myocardial Infarction Re-Revascularization Rate is High in Patients With High-Lp(a)

“…29 Tamura et al examined the association between serum Lp(a) level and angiographically assessed coronary artery disease progression without new myocardial infarction, and reported a close association. 30 Igarashi et al reported that an elevated Lp(a) concentration is a significant predictor of long-term adverse outcome in AMI patients treated by primary percutaneous transluminal coronary angioplasty. 27 In this study, we demonstrated that coronary stenosis progression occurred and revascularizations for target restenotic lesions or new lesions were performed approximately 7 months after the onset of the first myocardial infarction in the patients who had serum Lp(a) ≥30 mg/dl; that is, CCSP occurred in a relatively short period after the onset of the first AMI in the high-Lp(a) patients.…”