Correlation of lipoprotein(a) levels and myocardial stress thallium scintigraphy pattern in different entities of CHD severity.
BACKGROUND
Higher levels of lipoprotein(a) confer an increased risk for coronary heart disease (CHD). Apo-E genotype (APO-E) also plays a role, the APO-E epsilon 4 allele being associated with CHD. Furthermore, higher Lp(a) concentrations are correlated with APO-E epsilon 4 allele presence. The study was performed to investigate the relationship of Lp(a) and APO-E with the functional status of coronary arteries as evaluated by myocardial scintigraphy.


METHODS
We studied 70 patients (27 F and 43 M; mean age: 55 +/- 6 yrs.) consecutively referred for CHD, and 50 normal sex and age-matched controls. Total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, apo-AI, apo-B, Lp(a) levels (ELISA), Lp(a) isoforms (Immuno Blotting) and APO-E (PCR) were measured in all subjects. Only CHD patients underwent a myocardial tomographic stress thallium scintigraphy (201Tl-SPECT); the SPECT pattern was classified as follows: no perfusion defects (unstable angina group = 1), reversible defects at stress images (ischemia group = 2), fixed defects (infarction group = 3).


RESULTS
Lp(a) medians were significantly higher than controls in group 1 (p < 0.05), 2 (p < 0.001) and 3 (p = 0.00). Low molecular weight isoforms (B, S1, S2) were significantly more frequent in all CHD-patients vs. controls (p < 0.05), whereas APO-E genotypes did not differ among controls and patients. Multiple regression analysis showed family history (p < 0.001) to be the only independent predictive variable of CHD severity correlated to the scintigraphic pattern.


CONCLUSIONS
Among the considered biological parameters in our patients only Lp(a) plasma levels are related to the entity of ischemic cardiac wall damage as evaluated by 201Tl-SPECT.
Palumbo
Barbara
B
Department of Radiological Sciences, University of Perugia, Monteluce University Hospital, Via Brunamonti, I-06124 Perugia, Italy. mednuc@unipg.it
Lupattelli
Graziana
G
Siepi
Donatella
D
Bianchi
Andrea
A
Anniboletti
Pier Fabrizio
PF
Blandini
Vittoria
V
Sinzinger
Helmut
H
Mannarino
Elmo
E
Palumbo
Renato
R
D000483:Alleles; D001057:Apolipoproteins E / Q000235:genetics*; D016009:Chi-Square Distribution; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000097:blood* / Q000000981:diagnostic imaging* / Q000235:genetics; D003627:Data Interpretation, Statistical; D004797:Enzyme-Linked Immunosorbent Assay; D005080:Exercise Test; D005260:Female; D005838:Genotype; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D015151:Immunoblotting; D017270:Lipoprotein(a) / Q000097:blood* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D020033:Protein Isoforms; D012044:Regression Analysis; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014280:Triglycerides / Q000097:blood
D001057:Apolipoproteins E; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D017270:Lipoprotein(a); D020033:Protein Isoforms; D013794:Thallium Radioisotopes; D014280:Triglycerides; D002784:Cholesterol