Association of lipoprotein(a) and apolipoprotein(a) phenotypes with coronary and carotid atherosclerosis in CHD men

Aim. To evaluate in a case-control cross-sectional study whether lipoprotein(a) concentration and apo(a) phenotypes are associated with the presence and severity of coronary and carotid atherosclerosis. Materials and methods. We have examined 198 male CHD patients (mean age 53+/-8) years) with stenosis more than 50% at least in one main coronary artery or its major branches. Duplex scanning was performed in 168 patients to assess the degree of carotid atherosclerosis. Seventy six apparently healthy men (mean age 39+/-9 years) formed the control group. Lp(a) concentration was measured by ELISA, apo(a) phenotyping was performed by immunoblotting. Results. Lp(a) level was significantly higher in cases compared to controls: 37+/-31 mg/dl vs. 18+/-27 mg/dl, p<0.05. Patients had low-molecular weight apo(a) phenotypes more frequently than controls: 46% vs. 29%, p=0.01. Patients aged 45 years and younger had low-molecular weight apo(a) phenotypes more frequently than older ones (65% vs. 42%, p<0.05) and controls (65% vs. 29%, respectively, p=0.001). High Lp(a) level and low-molecular weighs apo(a) phenotypes correlated with presence and number of coronary occlusions. Conclusion. There was association between Lp(a) level, low-molecular weight apo(a) phenotypes and presence, severity, extension of carotid atherosclerosis. No differences in distribution of other CHD risk factors among all subgroups of patients were found.