ELEVATED PLASMA LIPOPROTEIN(A) ASSOCIATED WITH ABNORMAL STRESS THALLIUM SCANS IN CHILDREN WITH FAMILIAL HYPERCHOLESTEROLEMIA

Plasma lipoprotein(a) (Lp(a)) concentrations are associated with an in creased risk of coronary artery disease in adults with familial hyperc holesterolemia (FH). We hypothesized that Lp(a) concentrations in chil dren with FH were higher among those with myocardial ischemia on stres s thallium scans and among those with a family history of premature co ronary artery disease. Twenty-nine asymptomatic heterozygotes with FH (range 9 to 23 years) and 7 homozygotes (range 4 to 13 years) were eva luated with clinical assessment, lipoprotein measurement and stress th allium scans. Compared with subjects with normal stress thallium scans , mean Lp(a) was significantly higher in homozygotes with stress thall ium abnormalities (79 +/- 18 vs 15 +/- S.5 mg/dl, p = 0.03), and tende d to be higher in heterozygotes with stress thallium abnormalities (39 +/- 12 vs 20 +/- 4.2 mg/dl, p = 0.10). Lp(a) tended to be higher in h eterozygotes with a family history of premature coronary artery diseas e (30 +/- 6.4 vs 14 +/- 4.1 mg/dl, p = 0.12). It is concluded that Lp( a) is higher in hypercholesterolemic children who have abnormal stress thallium scans. Lp(a) may be useful in assessing coronary artery dise ase risk in children with FH.