[Lipoprotein(a) in heterozygote familial hypercholesterolemia]

Familial hypercholesterolemia (FH) is the genetic lipid disorder with a higher risk to develop coronary heart disease (CHD). In the heterozygous patients there are, however, variability in the atherosclerosis age of onset and severity. In recent years, it has been reported elevated levels of Lp(a) in FH, and it is proposed that this lipoprotein contributes to the development of CHD in these patients. This study evaluates the relationship between Lp(a) levels and the presence of CHD in FH. We included 38 patients with heterozygous FH with or without CHD (13 and 25 respectively), and a control group. In comparison to the control group, FH patients had significant elevated levels of Lp(a) (median 8.1 vs 16 mg/dL), and a greater prevalence of hyper Lp(a) (with a cut-off level of 30 mg/dL) (11.4 vs 25.7%). FH patients with CHD had higher levels of Lp(a) than those without CHD (22.8 vs 14.4 mg/dL). A significative negative correlation between age of onset of CHD and Lp(a) levels was found in females. CHD in FH was associated with male gender, older age, higher prevalence of hypertension, higher waist/hip ratios, higher levels of triglycerides and prevalence of hypertriglyceridemia. Our findings suggest that Lp(a) may play a role as an additional risk factor to develop atherosclerosis in FH.