PLASMA-LIPOPROTEIN (A) CONCENTRATION AND POSTANGIOPLASTY RESTENOSIS

Lipoprotein (a) [Lp(a)] is an independent genetically determined marke r of coronary artery disease. It is present in the atheromatous plaque with a molecular structure similar to that of plasminogen. Its role i n postangioplasty restenosis is a possibility but is controversial. A population of 103 coronary patients underwent angioplasty with control coronary angiography before the 6th month; there were 53 good results and SO cases of restenosis. The Lp(a) was measured by immunonepheleme try (threshold value of 250 mg/l). A subgroup with Lp(a) concentration s > 250 mg/l was identified. The average concentrations of Lp(a) in th e two groups without restenosis (368 +/- 350 mg/l) and with restenosis (418 +/- 434 mg/l) were not statisticaly different (p = 0.2). When ca ses with Lp(a) > 250 mg/l were considered alone, the tendency to highe r average concentrations of Lp(a) in the group with restenosis (777 +/ - 424 mg/l) compared with the group without restenosis (656 +/- 340 mg /l) was more clear-cut but did not achieve statistical significance (p = 0.08). The individual scatter of Lp(a) being very wide (83 to 1450 mg/l in the group without restenosis and 90 to 1740 mg/l in the group with restenosis), it is impossible to predict restenosis from this par ameter in a given individual. No correlations were observed between th e different lipid fractions and restenosis. The extension of the lesio ns and the angioplasty site did not correlate with restenosis in this study. The authors conclude : 1) that the Lp(a) concentration has no i ndividual predictive value for restenosis ; 2) individuals with Lp(a) concentrations > 250 mg/l have an increased risk of restenosis (NS); 3 ) these results confirm other recent publications; and 4) further rese arch into the isoforms of Lp(a) in each group could provide interestin g data.