Barbir M, Kushwaha S, Hunt B, Macken A, Thompson G R, Mitchell A, Robinson D, Yacoub M
Harefield Hospital, Middlesex, UK.
Lancet. 1992;340(8834-8835):1500-2. doi: 10.1016/0140-6736(92)92756-6.
High concentrations of serum lipoprotein(a) (Lp(a)) are associated with an increased risk of atherosclerotic vascular disease in the nontransplanted population. However, its relation with accelerated coronary artery disease (CAD) in cardiac transplant recipients has not been reported. We measured serum Lp(a) in 130 cardiac transplant recipients undergoing routine follow-up, which included annual coronary angiography. The median Lp(a) concentration in 33 patients with CAD was 71 mg/dl, which was significantly higher than the corresponding value of 22 mg/dL in the 97 patients without CAD (p = 0.0006). Multivariant analysis showed the serum Lp(a) value to be a higher significant risk factor for CAD irrespective of the other factors included in the regression analysis. Thus a high concentration of serum Lp(a) is an important, independent risk factor for the development of accelerated CAD in transplant recipients.
在非移植人群中，高浓度血清脂蛋白(a) [Lp(a)]与动脉粥样硬化性血管疾病风险增加相关。然而，其与心脏移植受者冠状动脉疾病（CAD）加速进展的关系尚未见报道。我们对130例接受常规随访（包括每年冠状动脉造影）的心脏移植受者测定了血清Lp(a)。33例CAD患者的Lp(a)浓度中位数为71mg/dl，显著高于97例无CAD患者的相应值22mg/dL（p = 0.0006）。多变量分析显示，无论回归分析中纳入的其他因素如何，血清Lp(a)值都是CAD的一个高度显著风险因素。因此，高浓度血清Lp(a)是移植受者发生CAD加速进展的一个重要独立风险因素。
