Increased lipoprotein (a) levels as an independent risk factor for venous thromboembolism

Elevation of serum Lipoprotein (a) (Lp[a]) is a known risk factor predispos ing to cardiovascular and cerebrovascular disease. However, little is known about the role of increased Lp(a) in venous thromboembolism (VTE). This st udy evaluated the role of Lp(a) among a panel of established hereditary thr ombogenic defects in patients with VTE, A total of 685 consecutive patients with at least one episode of VTE and 266 sex- and age-matched healthy cont rols were screened with regard to activated protein C resistance, protein C , protein S, and antithrombin deficiency, elevated serum levels of Lp(a), a nd the factor V G1691A, MTHFR C677T, and prothrombin G20210A mutations, Ele vated Lp(a) levels above 30 mg/dL were found in 20% of all patients, as com pared to 7% among healthy controls (P < .001, odds ratio [OR] 3.2, 95% conf idence interval [Cl], 1.9-5.3), The coexistence of FV G1691A and elevated L p(a) was significantly more prevalent among patients with VTE than in the c ontrol group (7% versus 0.8%; P < .001, OR 9.8, 95% CI, 2.4-40.7), No other established prothrombotic risk factor was found to be significantly combin ed with increased Lp(a), These data suggest that Lp(a) concentrations great er than 30 mg/dL are a frequent and independent risk factor for VIE, Furthe rmore, elevated Lp(a) levels might contribute to the penetrance of thromboe mbolic disease in subjects being affected by other prothrombotic defects, s uch as FV G1691A mutation. (C) 2000 by The American Society of Hematology.