Serum Lipoprotein (a) levels in Thromboangiitis Obliterans: A case control study

BACKGROUND: Thromboangiitis obliterans is a vasculopathy with limited management options. Lipoprotein (a) has been reported to be elevated in these patients. The purpose of this study was to determine lipoprotein(a) levels in them and to determine its association with severity of the disease if any. Aims and Objectives AIM OF THE STUDY: To study the association between lipoprotein (a) levels and thromboangiitis obliterans. OBJECTIVES: 1. To compare the levels of lipoprotein (a) in TAO to age and sex matched controls. 2. To study the association between lipoprotein (a) levels and severity of disease in TAO. STUDY DESIGN: Prospective case control study. SETTING: Tertiary care hospital in South India. MATERIAL & METHODS: We prospectively studied 45 cases of TAO and 45 age and gender matched controls. A detailed history was taken, physical examination done and Lp(a) levels determined on a fasting blood sample. Cases and controls were compared. RESULTS: The frequency distribution among cases and controls showed no difference with Lp(a) cut-off value of 30mg/dl. But on further categorization of Lp(a) Into 30-100 and >100mg/dl there was a very highly significant difference (p=0.003). The mean lipoprotein(a) value was also significantly more among cases (70.19mg/dl) than controls (40.86mg/dl), p value 0.0086. There was no association between increasing levels of Lp(a) and Ankle Brachial Pressure Index, duration of symptoms or pattern of vascular involvement (p >0.05). But there was definite increased occurrence of amputations with increasing Lp(a) levels, being 8.3% and 70% among those with levels 100mg/dl respectively (p=0.004). CONCLUSIONS: There was definite association of very high levels of Lipoprotein (a) in cases compared to controls and also with need for amputations