LIPOPROTEIN(A) AND HEMOSTASIS ACTIVATION MARKERS, IN ANGINA-PECTORIS

Statement of problem: To analyse whether lipoprotein(a) is a risk fact or for myocardial infarction, stroke and acute peripheral arterial occ lusion in coronary heart disease and whether this risk can be assessed by clotting activation markers. Patients and methods: A partly prospe ctive, partly retrospective study of data on 237 consecutive patients (201 men, 36 women; mean age 55 [24-76] years) who had undergone coron ary arteriography because of severe angina. Concentrations were measur ed for: beta-thromboglobulin, platelet factor 4, fibrinopeptide A, D-d imeres, thrombin-antithrombin III factor (TAT), prothrombin fragments 1 + 2, lipoprotein(a), apolipoprotein A-I (apoA-I), cholesterol and tr iglycerides. Analysis of any relationship between tween the findings o n coronary arteriography (degree of stenosis) and the occurrence of my ocardial infarction, stroke and acute peripheral arterial occlusion be fore and during the 2 years after the arteriography. Results: There wa s no correlation between lipid parameters and clotting or platelet act ivation markers. Patients with a history of acute peripheral arterial occlusion had raised values for lipoprotein(a) and TAT. In the prospec tive part of the study (i.e. during the first 2 years after blood samp les had been taken), there was no correlation. Conclusions: In patient s with coronary artery disease and angina pectoris no correlation was found between lipoprotein(a) and haemostasis activation markers. None of these parameters - prospectively evaluated - could pre diet risk of thromboembolism.