Lipoprotein (a) level and graft patency in a year after coronary artery bypass surgery

Relation of concentration of lipoprotein(a) [Lp(a)], total cholesterol (TC) , triglycerides (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), apo lipoprotein Al (apoAl) and apolipoprotein B (apoB) with patency of grafts d uring the first postoperative year was studied in 85 male patients (mean ag e 52,0+/-8,6 years). Crafts were visualized 5,3+/-3,0 months after surgery by standardized selective injection of a contrast agent in 31 and by noninv asive three-dimensional electron beam contrast tomography - in 54 patients. Patency of 196 autovenous and 72 autoarterial grafts was examined. Compari son of traditional risk factors and blood lipid profile between groups of p atients with greater than or equal to 1 occluded vein graft and all vein gr afts patent showed that there was difference only in a Lp(a) level (26+/-34 and 47+/-42 mg/dl, respectively, p=0,02). In patients with Lp(a) level >30 mg/dl the number of occluded vein grafts was considerably higher than in p atients with lower Lp(a) concentration (p =0,006). Patients treated with st atins in postoperative period compared with patients not treated with stati ns had smaller number of occluded vein grafts (p=0,01) and lower levels of TC and LDL-C (TC - 5,8+/-1,3 and 6,7+/-1,3 mmol/l, respectively p=0,0001; L DL-C - 3,9+/-1,5 and 4,7+/-1,1 mmol/l, respectively, p=0,0004). Patency of autoarterial grafts was not related to parameters of lipid profile and trad itional risk factors of atherosclerosis, such as: age, smoking, hypertensio n, family history of CHD. Conclusion. Lp(a) concentration can be used as a biochemical marker of risk of vein graft occlusion during the first year af ter CABG.