[The importance of lipoprotein(a) as a predictive factor of coronary atherosclerosis]

Abstract

Objective: The predictive value of lipoprotein(a), Lp(a), for coronary artery disease, is strongly suspected, though unproven. The normal serum level is 0.3 g/l. We searched for correlations between serum Lp(a) levels and coronary artery disease in a population of patients hospitalized in a general cardiology unit.

Method: Serum Lp(a) was assayed in all patients consecutively hospitalized during 1994 in the Valence hospital cardiology unit. Two groups were distinguished: patients with coronary artery disease (n = 444) and those presumed free of coronary artery disease (n = 555). Coronography were performed when required. Serum Lp(a) levels were compared for the following variables: age, sex, smoking habits, blood pressure, total cholesterol, HDL and LDL-cholesterol, triglycerides and apolipoproteins A1 and A2. Univariate, then multivariate analysis were performed first patients of all ages, then for those aged more and less than 60 years.

Results: Univariate analysis demonstrated that Lp(a) > 0.3 g/l was associated with coronary heart disease (OR = 1.33; p = 0.03), although this correlation was no longer significant after adjustment for other known risk factors (OR = 1.28; p = 0.07), except in the subgroup of patients over 60 years of age (OR = 1.37; p = 0.04).

Conclusion: There was a non-significant trend favoring an association between serum Lp(a) level > 0.3 g/l and the development of coronary artery disease.