Serum lipoprotein(a) changes in acute myocardial infarction

Background. A strong correlation between high serum Lp(a) levels, a genetic modification of cholesterol-low density lipoproteins (e-LDL), and increase d coronary heart disease rate has been found. Transient increased serum lev els of this lipoprotein during acute myocardial infarction (AMI) and surgic al interventions have been found. Methods. Experimental design: we assessed complete lipidic pattern in a stu dy series composed of 19 patients with AML We also evaluated the changes of Lp(a) serum levels within the first week of the disease in order to assess whether a correlation between this parameter and extent of necrotic myocar dial area is present. Patients: study series was made up of 19 patients (13 males, 6 females; mean age 57.94 +/- 10.7 years) with AMI compared to 25 c ontrol subjects (12 males and 13 females; mean age 51.12 +/- 15.34 years). Measures: we also withdrew a blood sample on days 1, 3 and 7 from the onset of the AML On the first day we evaluated the serum levels of the following parameters: glycaemia, azotemia, creatininemia, urycaemia, total cholester ol, high density lipoprotein cholesterol (c-HDL), low density lipoprotein c holesterol (c-LDL), triglycerides, fibrinogen, creatinphosphokinase, aspart ate aminotranspherase, thromboplastine time and prothrombinic activity. Lp( a) has been evaluated on day 1, 3 and 7 and after 6 months from AML We perf ormed an ultrasound scanning (US) of the heart in day 7 for evaluation of t he extent of necrotic myocardial area by observation of "segmental kinetic area". Results. Mean basal Lp(a) serum level was 28.94 +/- 29.78 mg/dl (as median 17), (normal values 0 to 25 mg/dl). This value was not changed on day 3 (me an 29.47 +/- 30.46 mg/dl, median 18), while significantly increased on day 7 (39.84 +/- 42.77, median 26, p = 0.05). Spearman's rank correlation test showed a strong correlation between the increase of Lp(a) serum levels on d ay 7 and extent of necrotic myocardial area (r = 0.696, p = 0.001). Conclusions. The positive correlation between mean Lp(a) values on day 1 an d 7, and the size of the necrotic area, suggest that Lp(a) has an atherogen ic and prothrombotic role. Moreover, elevated Lp(a) values were related to greater tissue damage. We believe that periodical determination of Lp(a) va lues in subjects with coronary disease is useful in order to predict furthe r acute vascular events.