Lipoprotein (a) in patients with aortic aneurysmal disease.
OBJECTIVE
Lipoprotein (a) is an independent risk factor for atherosclerosis. Atherosclerotic degeneration is usually found in abdominal aortic aneurysms (AAAs), whereas thoracic aortic aneurysms (TAAs) caused by aortic dissection are not suggested to be linked pathogenetically to atherosclerosis. Lipoprotein (a) was analyzed in patients with AAA and TAA and in healthy individuals in relation to the extent of atherosclerosis.


METHODS
Included in the case control study were patients with AAA (n = 75) and TAA with dissection (n = 39) and healthy control subjects (n = 43), for a total of 157 participants. Serum lipoprotein (a) was measured with nephelometry. Lipoprotein (a) levels were compared between age-matched and gender-matched paired samples of the three groups, and an association of lipoprotein (a), aortic aneurysm, and the extent of atherosclerosis was determined in multivariate analysis.


RESULTS
Median lipoprotein (a) levels of patients with AAA and TAA and of control subjects were 18.9 mg/dL (interquartile range [IQR], <9.6 to 40.5), less than 9.6 mg/dL (IQR, <9.6 to 16.7), and less than 9.6 mg/dL (IQR, <9.6 to 16.3), respectively. Lipoprotein (a) was positively associated with the extent of atherosclerosis in patients and control subjects (P <.0001). Lipoprotein (a) levels of patients with AAA were significantly higher compared with patients with TAA (P <.0001) and control subjects (P <.0001). Multivariate analysis confirmed an independent association between lipoprotein (a) and AAA (P =.009). No significant differences of lipoprotein (a) were found between patients with TAA and control subjects (P =.3).


CONCLUSIONS
The lipoprotein (a) serum level, an indicator of atherosclerosis, is significantly elevated in patients with abdominal aneurysms independently of cardiovascular risk factors and the extent of atherosclerosis. Patients with TAAs caused by dissection have lipoprotein (a) levels comparable with healthy individuals.
Schillinger
Martin
M
Department of Angiology, University of Vienna, Medical Faculty, Austria. martin.schillinger@akh-wien.ac.at
Domanovits
Hans
H
Ignatescu
Michaela
M
Exner
Markus
M
Bayegan
Keywan
K
Sedivy
Roland
R
Polterauer
Peter
P
Laggner
Anton N
AN
Minar
Erich
E
Kostner
Karam
K
D000368:Aged; D000784:Aortic Dissection / Q000097:blood / Q000150:complications / Q000453:epidemiology; D017544:Aortic Aneurysm, Abdominal / Q000097:blood* / Q000150:complications* / Q000453:epidemiology; D017545:Aortic Aneurysm, Thoracic / Q000097:blood* / Q000150:complications* / Q000453:epidemiology; D001161:Arteriosclerosis / Q000097:blood / Q000150:complications / Q000453:epidemiology; D001317:Austria / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors
D015415:Biomarkers; D017270:Lipoprotein(a)