Franceschini G, Cofrancesco E, Safa O, Boschetti C, Tremoli E, Mussoni L, Sirtori C R, Cortellaro M
E. Grossi Paoletti Center, Institute of Pharmacological Sciences, University of Milan, Italy.
Thromb Res. 1995 May 1;78(3):227-38. doi: 10.1016/0049-3848(95)00052-s.
Elevated plasma levels of lipoprotein(a) [Lp(a)] have been associated with an increased risk of cardiovascular disease. The aim of the present study was to investigate whether Lp(a) plasma levels were associated with subsequent ischemic events and with fibrinolytic variables in patients with established atherosclerotic disease enrolled in the prospective PLAT study. Lp(a) levels and fibrinolytic variables in 37 atherosclerotic patients who subsequently developed an atherothrombotic event during the first year of follow-up (cases) were compared with those in paired controls, matched for age, sex, diagnosis at enrollment and lipid pattern, who remained free from vascular events during the same time frame. Median and mean Lp(a) levels were similar in cases (6.05 mg/dl; 13.8 +/- 19.4 mg/dl) and controls (6.05 mg/dl; 17.1 +/- 21.6 mg/dl). In the whole group plasma Lp(a) levels correlated significantly with the increase of t-PA antigen (r = 0.368; p = 0.002) and fibrinolytic activity (r = 0.410; p = 0.001) induced by venous stasis but not with baseline fibrinolytic variables. These findings indicate that in patients with established atherosclerotic disease Lp(a) may interfere in vivo with the fibrinolytic process but is not predictive of subsequent ischemic events.
血浆脂蛋白(a)[Lp(a)]水平升高与心血管疾病风险增加相关。本研究的目的是调查在纳入前瞻性PLAT研究的已确诊动脉粥样硬化疾病患者中，Lp(a)血浆水平是否与随后的缺血事件以及纤溶变量相关。将37例在随访第一年发生动脉粥样硬化血栓形成事件的动脉粥样硬化患者（病例组）的Lp(a)水平和纤溶变量与配对对照组进行比较，对照组在年龄、性别、入组诊断和血脂模式方面进行匹配，且在同一时间段内未发生血管事件。病例组[中位数和平均值分别为6.05mg/dl；13.8±19.4mg/dl]和对照组[中位数和平均值分别为6.05mg/dl；17.1±21.6mg/dl]的Lp(a)水平相似。在整个研究组中，血浆Lp(a)水平与静脉淤滞诱导的组织型纤溶酶原激活物(t-PA)抗原增加(r = 0.368；p = 0.002)和纤溶活性(r = 0.410；p = 0.001)显著相关，但与基线纤溶变量无关。这些发现表明，在已确诊动脉粥样硬化疾病的患者中，Lp(a)可能在体内干扰纤溶过程，但不能预测随后的缺血事件。
