Levels of lipoprotein (a) in pulmonary arterial hypertension

We compared the levels of lipoprotein (a) in 48 Caucasian patients with pul monary arterial hypertension, comprising 32 females and 16 males, aged 28.0 +/- 12.0 years, with a range from 4 through 52 years, with 48 normal Cauca sian subjects matched for age and sex. Pulmonary hypertension was secondary in 41 patients with Eisenmenger's syndrome, these comprising 27 females an d 14 males aged 27.0 +/- 12.0 years, with a range from 4 through 51 years, and primary in the other 7 patients, 5 females and 2 males, whose age was 3 0.0 +/- 14.0 years, with a range from 9 through 52 years. Lipoprotein (a) w as measured using an immunoprecipitation and turbidimetric assay after a 12 hour fast. Levels of the protein, expressed as the median(% 25; % 75), wer e higher in those with Eisenmenger's syndrome than in normal controls (p=0. 003). In addition, there was a greater prevalence of levels of lipoprotein greater than 30.0 mg/dl in those with secondary pulmonary arterial hyperten sion patients than in our normal population (p = 0.03). We have found no di fferences, however, in the levels of lipoprotein (a) in those who had prima ry pulmonary arterial hypertension when compared with their matched control s, albeit that the number of patients studied was small. We conclude that i ncreased levels of lipoprotein (a) may be secondary to pulmonary arterial h ypertension as a marker of tissue damage or may be genetically determined. In either way, the increase in lipoprotein (a) could be an additional facto r predisposing to the vascular alterations known to occur in this disease.