Tsakiris D A, Riesen W F, Marbet G A
Departement Zentrallaboratorium, Universitätskliniken, Kantonsspital Basel, Schweiz.
Dtsch Med Wochenschr. 1995 Aug 18;120(33):1109-13. doi: 10.1055/s-2008-1055451.
To analyse whether lipoprotein(a) is a risk factor for myocardial infarction, stroke and acute peripheral arterial occlusion in coronary heart disease and whether this risk can be assessed by clotting activation markers.
A partly prospective, partly retrospective study of data on 237 consecutive patients (201 men, 36 women; mean age 55 [24-76] years) who had undergone coronary arteriography because of severe angina. Concentrations were measured for: beta-thromboglobulin, platelet factor 4, fibrinopeptide A, D-dimers, thrombin-antithrombin III factor (TAT), prothrombin fragments 1 + 2, lipoprotein(a), apolipoprotein A-I (apoA-I), cholesterol and triglycerides. Analysis of any relationship between the findings on coronary arteriography (degree of stenosis) and the occurrence of myocardial infarction, stroke and acute peripheral arterial occlusion before and during the 2 years after the arteriography.
There was no correlation between lipid parameters and clotting or platelet activation markers. Patients with a history of acute peripheral arterial occlusion had raised values for lipoprotein(a) and TAT. In the prospective part of the study (i.e. during the first 2 years after blood samples had been taken), there was no correlation.
In patients with coronary artery disease and angina pectoris no correlation was found between lipoprotein(a) and haemostasis activation markers. None of these parameters--prospectively evaluated--could predict risk of thromboembolism.
分析脂蛋白(a)是否为冠心病中心肌梗死、中风和急性外周动脉闭塞的危险因素，以及这种风险是否可通过凝血激活标志物进行评估。
对237例因严重心绞痛接受冠状动脉造影的连续患者（201例男性，36例女性；平均年龄55[24 - 76]岁）的数据进行了一项部分前瞻性、部分回顾性的研究。测量了以下指标的浓度：β-血小板球蛋白、血小板因子4、纤维蛋白肽A、D - 二聚体、凝血酶 - 抗凝血酶III因子（TAT）、凝血酶原片段1 + 2、脂蛋白(a)、载脂蛋白A - I（apoA - I）、胆固醇和甘油三酯。分析冠状动脉造影结果（狭窄程度）与造影前及造影后2年内心肌梗死、中风和急性外周动脉闭塞发生情况之间的任何关系。
血脂参数与凝血或血小板激活标志物之间无相关性。有急性外周动脉闭塞病史的患者脂蛋白(a)和TAT值升高。在研究的前瞻性部分（即采血后的前2年），无相关性。
在冠心病和心绞痛患者中，脂蛋白(a)与止血激活标志物之间未发现相关性。这些参数经前瞻性评估均无法预测血栓栓塞风险。
