[Lipoprotein(a) and hemostasis activation markers in angina pectoris].

STATEMENT OF PROBLEM

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.

PATIENTS AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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.