Lipoprotein(a) in Cerebrovascular and Coronary Atherosclerosis

Serum lipoprotein(a) [Lp(a)] was determined in 85 healthy controls (control group), in 49 patients with cerebrovascular disease (CVD group), and in 87 patients with acute myocardial infarction (AMI group). Lp(a) concentration was measured using a single radial immunodiffusion method. Because Lp(a) showed a skewed distribution, Lp(a) was plotted in each group on a box plot and analyzed using non-parametric methods. The following results were obtained: 1) Lp(a) levels were significantly higher in both the AMI and CVD groups than in the control group. 2) The CVD group was divided into 4 groups: [1] cerebral hemorrhage (HEM); [2] cardioembolic infarction (EMB); [3] lacunar infarction (LAC); and [4] atherothrombotic infarction (THR). In the THR group, Lp(a) concentration was higher than those in the control and LAC groups. 3) In the CVD group, patients with an elevated Lp(a) value showed severe lesions in the major cerebral arteries evaluated by cerebral arteriograms. 4) In the AMI patients who underwent coronary angiography, the Lp(a) level showed a marked increase with an increase in the number of affected vessels. The correlation between coronary index (CI) and Lp(a) was also investigated. The lesion severity of coronary arteries was correlated with serum Lp(a) concentration. These results suggest that a high Lp(a) value is linked to atherosclerosis of the cerebral and coronary arteries, and influences its severity