[Evaluation of coronary risk: a new technique of measuring lipoprotein (a)]

The aim of this study was to assess the reliability of immuno-nephelemetric assay (INA) of lipoprotein (Lp(a)) compared with immuno-radiometric (IRMA) and immuno-enzymologic (ELISA) assays in a coronary (P1) and a non-coronary (P2) populations. The serums of 66 coronary subjects (P1) with an average age of 61.5 +/- 10 years and 137 non-coronary subjects (P2) with an average age of 54 +/- 12 years were analysed by the 3 techniques. The technical characteristics of the INA were: negligeable interference with plasminogen (PLG) (< 1/100) for PLG < 375 mg/l; excellent repeatability and reproducibility at low, medium and high concentrations, respectively 12.3 and 7.5%. 1.2 and 1.2%, 1.3 and 1.1%, low dependance on sample conservation (stable 5 days at +4 degrees C), excellent practicability (simple and quick automised analysis: 10 min). The linear correlations with the concentrations of Lp(a) were: excellent with INA/IRMA P1 and P2: 0.99; very good with INA/ELISA P1: 0.88 and P2: 0.85; very good between IRMA/ELISA P1: 0.91 and P2: 0.87. The average values of Lp(a) were 386 mg/l (INA), 339 mg/l (IRMA), 316 mg/l (ELISA) for P1, and 231 mg/l (INA), 212 mg/l (IRMA) and 153 mg/l (ELISA) for P2, with a significant difference between P1 and P2 with all three techniques: 0.0138 (INA), 0.0207 (IRMA) and 0.0001 (ELISA). The authors concluded that measuring Lp(a) by INA is reliable with respect to IRMA and ELISA techniques, as accurate, quicker, automatised and cheaper, compensating for a lower sensitivity, a calculated risk of a non-specific reaction and the necessity of a shorter delay of analysis. The comparative results in two populations demonstrate it to be an excellent marker of coronary risk for epidemiological studies, independant of other risk factors.