DIFFERENCES IN LIPOPROTEIN (A) AND APOLIPOPROTEIN (A) LEVELS IN MEN AND WOMEN WITH ADVANCED CORONARY ATHEROSCLEROSIS

Background: This study was designed to evaluate whether differences be tween sexes exist in serum-lipoprotein (a) [Lp(a)] and arterial-wall-a polipoprotein (a) [Apo(a)] levels in patients with advanced coronary a rtery disease. Methods: The concentrations of Lp(a) in serum and Apo(a ) in aortic biopsies were studied in 76 men and 20 women undergoing co ronary artery bypass graft surgery. The severity of coronary artery di sease was determined by a coronary atherosclerosis score that used qua ntitative coronary angiography. Results: Serum-Lp(a) and tissue-Apo(a) do not correlate with the severity of coronary artery disease as expr essed by the coronary atherosclerosis score (r=0.09 and r=0.14, respec tively). Women were older (65+/-8 versus 57+/- years, P<0.001) and had higher mean Lp(a) and higher mean Apo(a) revels (47+/-41 versus 32+/- 40 mg/dl and 33+/-34 versus 19+/-24 mu g/g wet weight, P<0.05) than me n with identical coronary atherosclerosis score (35+/-8 versus 33+/-8, P>0.05). The serum levels of cholesterol, triglycerides, and high-den sity lipoprotein were similar in bath groups. Conclusions: Men and wom en undergoing coronary artery bypass graft surgery had very similar se verity of coronary artery disease as expressed by the coronary atheros clerosis score. Women were 8 years older and had 1.5 times higher mean serum-Lp(a) levels and 1.75 times higher mean tissue Apo(a) levels th an the men. Sixty per cent of the women but only 39% of the men had se rum Lp(a) levels higher than 25 mg/dl. Lp(a) level seems to be an addi tional risk factor for coronary artery disease confined to postmenopau sal women.