Lipoprotein(a) levels and heart transplantation atherosclerosis.
BACKGROUND
Elevated serum lipoprotein(a) [Lp(a)] levels are associated with the development of native coronary atherosclerosis. The association between increased levels of Lp(a) and the development of accelerated cardiac allograft vasculopathy (ACAV) in patients who have undergone orthotopic heart transplantation has not been firmly established.


RESULTS
We studied 74 consecutive heart transplant recipients with at least 1 year survival to determine the relation between Lp(a) and the presence of ACAV. Recipient and donor clinical and laboratory parameters, including mean serum Lp(a) levels, were obtained. ACAV was defined angiographically as > or =30% stenosis in one or more epicardial arteries. ACAV 1 year after heart transplantation was angiographically present in 26 (35%) patients. Mean donor age (36 +/- 13 years [ACAV (+)] vs 28 +/- 10 years, [ACAV (-)]; p = 0.004) and mean serum triglyceride levels 6 months after transplantation (286 +/- 275 mg/dl [ACAV (+)] vs 169 +/- 85 mg/dl [ACAV (-)]; p = 0.025) were univariate predictors of ACAV. No significant difference in mean serum Lp(a) levels was observed (20 +/- 19 mg/dl [ACAV (+)] vs 30 +/- 30 mg/dl [ACAV (-)]; p = NS). Donor age was the single greatest independent predictor of ACAV by multivariate logistic regression (p = 0.02).


CONCLUSIONS
Lp(a) does not appear to be a risk factor for the development of ACAV 1 year after heart transplantation. Further studies are needed to define the influence of serum Lp(a) on the development of cardiovascular disease after orthotopic heart transplantation.
Chang
G
G
Cardiovascular Division, Department of Medicine, University of Pennsylvania Health System, Philadelphia 19104-4024, USA.
DeNofrio
D
D
Desai
S
S
Kelley
M P
MP
Rader
D J
DJ
Acker
M A
MA
Loh
E
E
D000328:Adult; D000367:Age Factors; D000368:Aged; D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000502:physiology*; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood* / Q000175:diagnosis; D012307:Risk Factors; D014019:Tissue Donors; D014280:Triglycerides / Q000097:blood
D017270:Lipoprotein(a); D014280:Triglycerides; D002784:Cholesterol