SERUM LP(A) LIPOPROTEIN CONCENTRATION IS NOT ASSOCIATED WITH CLINICALAND ANGIOGRAPHIC OUTCOME 5 YEARS AFTER CORONARY-ARTERY BYPASS GRAFT-SURGERY

Objective-To examine the association between serum Lp(a) lipoprotein c oncentration and clinical and angiographic outcomes five years after c oronary artery bypass graft (CABG) surgery. Setting--A regional cardio thoracic centre, Freeman Hospital, and the University Clinical Investi gation Unit, Royal Victoria Infirmary, Newcastle upon Tyne. Patients a nd design-353 consecutive patients (56 female, 297 male, mean age 57.2 years) undergoing first time CABG surgery for stable angina were stud ied prospectively. Main outcome measures-Late cardiac death (beyond 30 days) and non-fatal myocardial infarction; prevalence of angina five years after surgery in 291 (94%) survivors and vein graft patency (eva luated by patient) in 118 survivors five years after surgery. Serum Lp (a) concentration and lipid profiles were measured before operation, a nd 3, 6, 12, and 60 months after surgery. Lipid profiles were also mea sured 24 months after surgery. Results--Weighted Lp(a) concentration ( by tertile) was not associated with late cardiac death or with the com bination of late cardiac death and non-fatal myocardial infarction, wi th the presence of angina, or with vein graft occlusion. The associati on remained non-significant if analysis was restricted to the upper te rtile of LDL cholesterol (> 4.1 mmol/l) or to patients under the age o f 55 years at the time of surgery. Conclusions-Serum Lp(a) concentrati on did not predict late cardiac death, the combination of late cardiac death and non-fatal myocardial infarction, or the prevalence of angin a or vein graft occlusion five years after CABG surgery.