Apolipoprotein(a) phenotypes as genetic markers of coronary atherosclerosis severity.
We investigated Lp(a) levels and apo(a) polymorphism in relation to the severity of coronary artery disease, expressed both by the number of coronary arteries stenosed and three different coronary scoring systems. In a sample of 267 patients with coronary artery disease, a Mono-, Bi- or Multi-vessel coronary stenosis was documented by angiography. Twenty-five apo(a) isoforms were detected by a high resolution phenotyping method. Lp(a) levels did not show any differences among subgroups of patients. Both the percentage of apo(a) isoforms of low molecular weight (<655 kDa) (P=0.00015) and the percentage of subjects with at least one apo(a) isoform of low molecular weight (P=0.00027) were significantly correlated with increasing number of coronary vessels stenosed. In multivariate analysis, only apo(a) isoforms of low molecular weight were predictors of coronary atherosclerosis severity, when we used as the dependent variable both the '1-2-multi-vessels' categorization (P=0.000067) and the Gensini (P=0.008767), or Green Lane (P= 0.000001) or Dahlen (P=0.000102) coronary scoring system. Our data show that apo(a) isoforms of low molecular weight are associated with a greater severity of coronary atherosclerosis. If these data are confirmed by prospective studies, apo(a) phenotypes might be used as genetic markers of a greater severity of coronary atherosclerotic lesions.
Department of Internal Medicine and Medical Therapeutics, IRCCS Policlinico San Matteo, University of Pavia, Italy.
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C
Gazzaruso
D
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Geroldi
A
A
Garzaniti
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C
Falcone
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P
Fratino
G
G
Finardi
P
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Buscaglia
D000704:Analysis of Variance; D001054:Apolipoproteins A / Q000097:blood* / Q000235:genetics; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000235:genetics; D004587:Electrophoresis, Agar Gel; D005260:Female; D005819:Genetic Markers; D006801:Humans; D015151:Immunoblotting; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011110:Polymorphism, Genetic; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
D001054:Apolipoproteins A; D005819:Genetic Markers; D008055:Lipids