Increased plasma levels of lipoprotein(a) and the risk of idiopathic and recurrent venous thromboembolism.
OBJECTIVE
Elevated lipoprotein(a) [Lp(a)] levels are a recognized risk factor for cardiovascular disease; however, little is known about their effects on venous thromboembolism.


METHODS
We conducted a case-control study of 603 adult patients with a history of venous thromboembolism (at least 6 months after the acute event) and 430 healthy subjects. We measured Lp(a), homocysteine, and antithrombin levels, factor V Leiden and factor II (prothrombin) polymorphisms, and anticardiolipin antibodies.


RESULTS
Lp(a) levels >300 mg/L were found in 24% (n = 146) of the patients and in 13% (n = 58) of the controls (P = 0.005). In a multivariate analysis adjusted for acquired and hemostasis-related risk factors, there was an independent association between elevated (>300 mg/L) Lp(a) levels and venous thromboembolism (odds ratio = 2.1; 95% confidence interval: 1.4 to 3.2; P = 0.002). These results were confirmed in the 341 patients with idiopathic venous thromboembolism, as well as in those with recurrent thromboembolism.


CONCLUSIONS
These results show that Lp(a) is an independent risk factor for venous thromboembolism in adults, suggesting that it may be involved in the pathogenesis of idiopathic and recurrent disease.
Marcucci
Rossella
R
Dipartimento Area Critica Medico-Chirurgica, Clinica Medica Generale e Cardiologia, Florence, Italy.
Liotta
Agatina Alessandrello
AA
Cellai
Anna Paola
AP
Rogolino
Angela
A
Gori
Anna Maria
AM
Giusti
Betti
B
Poli
Daniela
D
Fedi
Sandra
S
Abbate
Rosanna
R
Prisco
Domenico
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015897:Comorbidity; D005165:Factor V / Q000235:genetics; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011516:Prothrombin / Q000235:genetics; D011655:Pulmonary Embolism / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D012008:Recurrence; D012307:Risk Factors; D013923:Thromboembolism / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*
D017270:Lipoprotein(a); C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin