[Lipoprotein(a) as a biochemical marker of coronary atherosclerosis]

The relation between lipoprotein Lp(a) levels, other lipids and severity of coronary atherosclerosis was studied in 281 patients (241 men and 40 women aged 24 to 68 years) with suspected or diagnosed coronary heart disease. All of them underwent coronary angiography. The angiograms were evaluated according to two scores: vessel score (0 to 3 points for 0 to 3 vessels with stenoses > 50%) and stenosis score (0 to 32 points, number and severity of coronary lesions). 224 patients with verified coronary atherosclerosis were grouped according to these scores and compared with subgroup of 57 patients with intact coronary arteries. Lp(a) levels were significantly higher in patients with 1-, 2- (p < 0.05) and 3-vessel (p < 0.01) disease and stenosis score more than 10 points (p < 0.01). LDL cholesterol (LDL-C) levels were significantly higher in patients with 2- and 3-vessel disease and stenosis score more than 10 points (p < 0.05 in all cases). There was a positive correlation between Lp(a) levels and severity of coronary atherosclerosis (p < 0.05). Lp(a) contributes < 15% of total plasma cholesterol (TC). After subtraction of Lp(a)-cholesterol from TC according to modified Friedewald formula there was no any correlation between Lp(a) and LDL-C levels.