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Christos S. Katsouras, Sonia A. Karabina, Afroditi P. Tambaki, John A. Goudevenos, Lambros K. Michalis, Loukas D. Tsironis, Christos S. Stroumbis, Moses S. Elisaf, Dimitris A. Sideris, Alexandros D. Tselepis, Serum Lipoprotein(a) Concentrations and Apolipoprotein(a) Isoforms: Association with the Severity of Clinical Presentation in Patients with Coronary Heart Disease, Journal of Cardiovascular Risk, Volume 8, Issue 5, 1 October 2001, Pages 311–317, https://doi.org/10.1177/174182670100800511
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Abstract
Objective The aim of this study was to investigate the possible associations between lipoprotein(a) [Lp(a)] concentrations or apolipoprotein(a) isoforms and the mode of clinical presentation of coronary heart disease (CHD) (acute thrombotic event or not).
Methods A total of 131 CHD patients and 71 age- and gender-matched individuals without known CAD (free of symptoms of heart disease) were enrolled in the study. CHD patients were classified into patients with a history of an acute coronary syndrome (ACS, n=94) and patients with stable angina (SA, n=37). Lp(a) levels were measured with an ELISA method, whereas apolipoprotein(a) isoform analysis was performed (in all patients and 33 controls) by electrophoresis in 1.5% SDS-agarose gels followed by immunoblotting. Isoform size was expressed as the number of kringle 4 (K4) repeats.
Results ACS patients had higher Lp(a) plasma levels [21.9 (0.8–84.1) mg/dl] and a greater proportion of elevated (≥ 30 mg/dl) Lp(a) concentrations (25.5%) compared with SA patients [9.2 (0.8–50.5) mg/dl, P < 0.01 and 10.8%, P < 0.05] and controls [8.0 (0.8–55.0) mg/dl, P < 0.01 and 11.2%, P < 0.05], while there were no differences between SA patients and controls. The median apolipoprotein(a)-isoform size was 26 K4. In 17 (10%) patients we could not detect any apolipoprotein(a) isoform bands by immunoblotting. ACS patients had a higher proportion of isoforms < 26 K4 (low molecular weight) than SA patients (56/85 vs. 12/33, P < 0.005) and controls (10/29, P < 0.005).
Conclusions CAD patients with a history of ACS have higher Lp(a) plasma levels and a significantly higher proportion of low molecular weight apolipoprotein(a) isoforms compared with patients with SA or to controls.
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