TY - JOUR
T1 - Relation of plasma lipoprotein(a) to infarct artery patency in survivors of myocardial infarction
AU - Moliterno, David J.
AU - Lange, Richard A.
AU - Meidell, Robert S.
AU - Willard, John E.
AU - Leffert, Carla C.
AU - Gerard, Robert D.
AU - Boerwinkle, Eric
AU - Hobbs, Helen H.
AU - Hillis, L. David
PY - 1993/9
Y1 - 1993/9
N2 - Background. In the minutes to days after myocardial infarction, endogenous lysis of an occlusive coronary arterial thrombus occurs in most subjects. Compared with those in whom thrombolysis does not occur, those with antegrade flow in the infarct artery have improved left ventricular performance, less left ventricular dilatation, and improved survival. This study was performed to assess intrinsic hemostasis and fibrinolysis in survivors of myocardial infarction with or without antegrade perfusion of the infarct artery. Methods and Results. In 105 survivors of infarction (75 men, 30 women; age, 30 to 80 years) not given thrombolytic therapy, coronary angiography revealed a patent (group 1, n=52) or occluded (group 2, n=53) infarct artery. Plasma concentrations of plasminogen, fibrinogen, tissue plasminogen activator activity, plasminogen activator inhibitor activity, cholesterol, triglycerides, and lipoproteins, including lipoprotein(a) (Lp[a]), were measured in blood procured 23±13 (mean±SD) months after infarction. Groups 1 and 2 were similar in age, sex, race, cardioactive medications, infarct artery, extent of coronary artery disease, and left ventricular performance. Of the plasma constituents assayed, the groups were similar except that Lp(a) averaged 18.5±21.7 mg/dL in group 1 and 49.1±44.8 mg/dL in group 2 (P<.001). This difference was evident in both Caucasian (n=65) (P=.009) and African American (n=40) (P=.01) subjects. Conclusions. Survivors of myocardial infarction who failed to recanalize the infarct artery have higher plasma Lp(a) concentrations than those with a patent infarct artery. Lp(a) may inhibit intrinsic fibrinolysis.
AB - Background. In the minutes to days after myocardial infarction, endogenous lysis of an occlusive coronary arterial thrombus occurs in most subjects. Compared with those in whom thrombolysis does not occur, those with antegrade flow in the infarct artery have improved left ventricular performance, less left ventricular dilatation, and improved survival. This study was performed to assess intrinsic hemostasis and fibrinolysis in survivors of myocardial infarction with or without antegrade perfusion of the infarct artery. Methods and Results. In 105 survivors of infarction (75 men, 30 women; age, 30 to 80 years) not given thrombolytic therapy, coronary angiography revealed a patent (group 1, n=52) or occluded (group 2, n=53) infarct artery. Plasma concentrations of plasminogen, fibrinogen, tissue plasminogen activator activity, plasminogen activator inhibitor activity, cholesterol, triglycerides, and lipoproteins, including lipoprotein(a) (Lp[a]), were measured in blood procured 23±13 (mean±SD) months after infarction. Groups 1 and 2 were similar in age, sex, race, cardioactive medications, infarct artery, extent of coronary artery disease, and left ventricular performance. Of the plasma constituents assayed, the groups were similar except that Lp(a) averaged 18.5±21.7 mg/dL in group 1 and 49.1±44.8 mg/dL in group 2 (P<.001). This difference was evident in both Caucasian (n=65) (P=.009) and African American (n=40) (P=.01) subjects. Conclusions. Survivors of myocardial infarction who failed to recanalize the infarct artery have higher plasma Lp(a) concentrations than those with a patent infarct artery. Lp(a) may inhibit intrinsic fibrinolysis.
KW - Apolipoproteins
KW - Fibrinolysis
KW - Thrombolysis
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U2 - 10.1161/01.CIR.88.3.935
DO - 10.1161/01.CIR.88.3.935
M3 - Article
C2 - 8353920
AN - SCOPUS:0027200591
SN - 0009-7322
VL - 88
SP - 935
EP - 940
JO - Circulation
JF - Circulation
IS - 3
ER -