Instituto Nacional de Cardiología "Ignacio Chávez", Departamentos de Biología Molecular, Mexico, D.F.
Clin Biochem. 2010 May;43(7-8):640-4. doi: 10.1016/j.clinbiochem.2010.01.013. Epub 2010 Feb 12.
OBJECTIVES: Identify whether the plasma concentration of Lp(a), apo(a) size or a greater affinity for fibrin predict the likelihood of cardiac death, non-fatal myocardial infarction, unstable angina, the need for additional revascularization, and stroke (MACCE). DESIGN AND METHODS: We analyzed the clinical prognosis of 68 patients with coronary artery disease included in a case-controlled study which evaluated Lp(a) concentration, apo(a) size, and Lp(a) fibrin-binding. Cohort was conducted over a median of 8 years. We used Kaplan-Meier survival tables to evaluate cardiovascular and cerebrovascular events in the follow-up period. RESULTS: Apo(a) isoforms of small size are predictors of MACCE. We find an association between Lp(a) concentration and apo(a) fibrin-binding with major adverse cardiovascular and cerebrovascular events, although without statistically significant results. CONCLUSIONS: Small-sized apo(a) isoforms are an independent risk factor for MACCE in patients with coronary artery disease in follow-up. Lp(a) plasma concentration and apo(a) fibrin-binding were associated, although not significant.
目的:确定 Lp(a)、载脂蛋白(apo)a 大小或与纤维蛋白更高的亲和力是否能预测心脏死亡、非致死性心肌梗死、不稳定型心绞痛、需要进一步血运重建以及中风(MACCE)的可能性。
设计和方法:我们分析了纳入病例对照研究的 68 例冠心病患者的临床预后,该研究评估了 Lp(a)浓度、apo(a)大小和 Lp(a)与纤维蛋白的结合。队列研究的中位随访时间为 8 年。我们使用 Kaplan-Meier 生存表评估随访期间心血管和脑血管事件。
结果:小尺寸的 apo(a)同种型是 MACCE 的预测因子。我们发现 Lp(a)浓度和 apo(a)与纤维蛋白的结合与主要不良心血管和脑血管事件之间存在关联,但没有统计学意义。
结论:在随访的冠心病患者中,小尺寸的 apo(a)同种型是 MACCE 的独立危险因素。Lp(a)血浆浓度与 apo(a)与纤维蛋白的结合有关,但无统计学意义。
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