Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria.
Sci Rep. 2024 Oct 29;14(1):25962. doi: 10.1038/s41598-024-77669-z.
Lipoprotein (a) [Lp(a)] is suspected to have antifibrinolytic effects, however, its relevance for the severity of venous thromboembolic events remains unclear. We studied the association of Lp(a) levels with thrombus load in pulmonary embolism (PE). 90 patients (40% female, median age 70 [56-79] years) at our tertiary care hospital with a diagnosis of acute PE, available Lp(a) levels and CT pulmonary angiography (CT-PA) performed between April 2017 and December 2019 were included. All CT-PA scans were reanalyzed and thrombus load was determined via Qanadli CT obstruction index (CTOI) and most proximal thrombus location. Median Lp(a) levels were 11.4 [9.3-29.1] mg/dL, median D-dimer levels were 4.6 [2.1-9.8] mg/L, median CTOI was 23 [8-50], central PE was present in 27 (30%) patients. Lp(a) did not correlate with CTOI (r = 0.02, p = 0.922) and was not associated with thrombus location (p = 0.369). CTOI significantly correlated with D-dimer (r = 0.43, p < 0.001) and right to left ventricular diameter ratio (r=-0.49, p = < 0.001). Our findings showed that Lp(a) is not associated with thrombus burden in PE, which suggests that a relevant effect of Lp(a) on the extent of venous thromboembolism is unlikely.
脂蛋白 (a) [Lp(a)] 被怀疑具有抗纤维蛋白溶解作用,但其与静脉血栓栓塞事件严重程度的相关性尚不清楚。我们研究了 Lp(a) 水平与肺栓塞 (PE) 血栓负荷的关系。我们的三级护理医院收治了 90 名急性 PE 患者(40%为女性,中位年龄 70[56-79]岁),这些患者的 Lp(a) 水平和 2017 年 4 月至 2019 年 12 月期间进行的 CT 肺动脉造影 (CT-PA) 都可用。对所有 CT-PA 扫描进行重新分析,并通过 Qanadli CT 阻塞指数 (CTOI) 和最接近血栓的位置确定血栓负荷。中位 Lp(a) 水平为 11.4[9.3-29.1]mg/dL,中位 D-二聚体水平为 4.6[2.1-9.8]mg/L,中位 CTOI 为 23[8-50],27 例(30%)患者存在中央型 PE。Lp(a) 与 CTOI 无相关性(r=0.02,p=0.922),与血栓位置无相关性(p=0.369)。CTOI 与 D-二聚体显著相关(r=0.43,p<0.001),与右室与左室直径比负相关(r=-0.49,p<0.001)。我们的研究结果表明,Lp(a) 与 PE 中的血栓负荷无关,这表明 Lp(a) 对静脉血栓栓塞程度的影响可能不大。
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