ELEVATED PLASMA LIPOPROTEIN(A) LEVEL AND ITS ASSOCIATION WITH IMPAIRED FIBRINOLYSIS IN PATIENTS WITH ANTIPHOSPHOLIPID SYNDROME

Objective. To assess the significance of lipoprotein(a) [Lp(a)], a ris k factor for atherothrombosis, and its relationship with fibrinolysis in a cohort of patients with antiphospholipid syndrome (APS). Methods. Plasma levels of Lp(a) were measured in 68 patients with APS (42 prim ary, 26 secondary to systemic lupus erythematosus), Results. Elevated plasma levels of Lp(a) were found in patients with APS compared to 22 healthy controls (p = 0.0001). The significance persisted after compar ing Lp(a) levels in 3 APS subgroups (arterial thrombosis, n = 37; veno us thrombosis, n = 31; recurrent miscarriages, n = 24) with those of c ontrols (p < 0.0001). Patients with APS with maximal elevation of Lp(a ) showed a lower fibrinolytic activity (lower D-dimer and higher plasm inogen activator inhibitor) than patients whose Lp(a) was within a nor mal range. Conclusion. These findings suggest that Lp(a) may represent a marker of APS and that Lp(a) has a negative effect on the fibrinoly tic system that might contribute to the thrombotic tendency of APS.