Plasma Lp(a) levels correlate with number, severity, and length-extension of coronary lesions in male patients undergoing coronary arteriography for clinically suspected coronary atherosclerosis.

T Budde, C Fechtrup, E Bösenberg, C Vielhauer, A Enbergs, H Schulte, G Assmann, G Breithardt
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引用次数: 109

Abstract

The relation between lipoprotein(a) [Lp(a)] as an independent risk factor for coronary atherosclerosis and the severity and extension of angiographically detectable coronary atherosclerotic lesions has not been systematically evaluated. In 118 male patients (54.3 +/- 7.4 years) with suspected coronary artery disease and without a history of myocardial infarction undergoing coronary angiography, the relation between plasma Lp(a) levels and other lipoproteins and the severity and extension of coronary lesions was studied. The coronary angiograms were evaluated in a blinded manner according to three scores: vessel score (0 to 3 points for 0 to 3 vessels with stenoses > or = 70%), stenosis score (0 to 32 points; number and severity of coronary stenoses or lesions), and extent score (0 to 100 points; length-extension of all coronary lesions in relation to the total coronary vessel length). The score values obtained were analyzed for correlations with age and levels of total cholesterol (6.08 +/- 1.26 mmol/L; mean +/- SD), high-density lipoprotein cholesterol (1.04 +/- 0.33 mmol/L), low-density lipoprotein cholesterol (4.18 +/- 1.15 mmol/L), triglycerides (1.88 +/- 1.37 mmol/L), and Lp(a) in plasma (19.5 +/- 22.6 mg/dL). Bivariate correlation analysis resulted in positive correlations between Lp(a) and vessel score (P < .01), stenosis score (P < .01), and extent score (P < .05). With multivariate analyses, besides Lp(a) plasma level (nl), only patient age showed a significant correlation to all three scores used, whereas none of the lipid parameters correlated significantly with all three scores.

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在临床疑似冠状动脉粥样硬化的男性患者行冠状动脉造影时,血浆Lp(a)水平与冠状动脉病变的数量、严重程度和长度延伸相关。
脂蛋白(a) [Lp(a)]作为冠状动脉粥样硬化的独立危险因素与血管造影检测到的冠状动脉粥样硬化病变的严重程度和范围之间的关系尚未得到系统的评估。对118例(54.3±7.4岁)无心肌梗死史的疑似冠状动脉疾病男性患者行冠状动脉造影,研究血浆Lp(a)及其他脂蛋白水平与冠状动脉病变严重程度及范围的关系。冠状动脉造影采用盲法评分:血管评分(0 ~ 3支血管狭窄>或= 70%者0 ~ 3分)、狭窄评分(0 ~ 32分;冠状动脉狭窄或病变的数量和严重程度)及程度评分(0 ~ 100分;所有冠状动脉病变的长度(与冠状动脉总长度的关系)。分析获得的评分值与年龄和总胆固醇水平的相关性(6.08 +/- 1.26 mmol/L;平均+/- SD),高密度脂蛋白胆固醇(1.04 +/- 0.33 mmol/L),低密度脂蛋白胆固醇(4.18 +/- 1.15 mmol/L),甘油三酯(1.88 +/- 1.37 mmol/L),血浆Lp(a) (19.5 +/- 22.6 mg/dL)。双因素相关分析显示,Lp(a)与血管评分(P < 0.01)、狭窄评分(P < 0.01)、范围评分(P < 0.05)呈正相关。通过多变量分析,除了Lp(a)血浆水平(nl)外,只有患者年龄与所使用的所有三个评分均有显著相关性,而脂质参数与所有三个评分均无显著相关性。
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