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[Lipoprotein(a) and hemostasis activation markers in angina pectoris]
D A Tsakiris1, W F Riesen, G A Marbet
1Departement Zentrallaboratorium, Universitätskliniken, Kantonsspital Basel, Schweiz.
Insights
Lipoprotein(a) and clotting markers do not predict thromboembolism risk in coronary artery disease patients. This study found no correlation between these markers and adverse cardiovascular events like myocardial infarction or stroke.
Area of Science:
- Cardiovascular Medicine
- Thrombosis Research
- Lipidology
Background:
- Coronary heart disease (CHD) patients face risks of myocardial infarction, stroke, and peripheral arterial occlusion.
- Investigating lipoprotein(a) [Lp(a)] as a potential risk factor in CHD is crucial.
- Assessing the role of clotting activation markers in conjunction with Lp(a) for risk stratification is needed.
Purpose of the Study:
- To determine if lipoprotein(a) is a risk factor for myocardial infarction, stroke, and acute peripheral arterial occlusion in patients with coronary heart disease.
- To evaluate whether clotting activation markers can predict the risk associated with lipoprotein(a) levels.
Main Methods:
- A study involving 237 patients with severe angina undergoing coronary arteriography.
- Measurement of various markers including beta-thromboglobulin, platelet factor 4, fibrinopeptide A, D-dimers, thrombin-antithrombin III factor (TAT), prothrombin fragments 1 + 2, lipoprotein(a), apolipoprotein A-I, cholesterol, and triglycerides.
- Analysis of correlations between arteriography findings, lipid parameters, clotting markers, and thromboembolic events (myocardial infarction, stroke, peripheral arterial occlusion) prospectively and retrospectively.
Main Results:
- No correlation was observed between lipid parameters and clotting or platelet activation markers.
- Patients with a history of acute peripheral arterial occlusion exhibited elevated levels of lipoprotein(a) and TAT.
- Prospective analysis over 2 years showed no correlation between the measured markers and subsequent thromboembolic events.
Conclusions:
- In patients with coronary artery disease and angina pectoris, no association was found between lipoprotein(a) and hemostasis activation markers.
- The studied parameters, when evaluated prospectively, did not serve as predictors for the risk of thromboembolism.
Statement Of Problem:
To analyse whether lipoprotein(a) is a risk factor for myocardial infarction, stroke and acute peripheral arterial occlusion in coronary heart disease and whether this risk can be assessed by clotting activation markers.
Patients And Methods:
A partly prospective, partly retrospective study of data on 237 consecutive patients (201 men, 36 women; mean age 55 [24-76] years) who had undergone coronary arteriography because of severe angina. Concentrations were measured for: beta-thromboglobulin, platelet factor 4, fibrinopeptide A, D-dimers, thrombin-antithrombin III factor (TAT), prothrombin fragments 1 + 2, lipoprotein(a), apolipoprotein A-I (apoA-I), cholesterol and triglycerides. Analysis of any relationship between the findings on coronary arteriography (degree of stenosis) and the occurrence of myocardial infarction, stroke and acute peripheral arterial occlusion before and during the 2 years after the arteriography.
Results:
There was no correlation between lipid parameters and clotting or platelet activation markers. Patients with a history of acute peripheral arterial occlusion had raised values for lipoprotein(a) and TAT. In the prospective part of the study (i.e. during the first 2 years after blood samples had been taken), there was no correlation.
Conclusions:
In patients with coronary artery disease and angina pectoris no correlation was found between lipoprotein(a) and haemostasis activation markers. None of these parameters--prospectively evaluated--could predict risk of thromboembolism.