title: Increased lipoprotein(a) is associated with polyvascular disease in patients undergoing coronary artery bypass graft.
abstract: OBJECTIVE
  We sought to identify clinical and biochemical predictors of disease in multiple vascular territories, in patients with established coronary heart disease.
  
  
  METHODS
  A total of 470 patients (329 men, 141 female) who had undergone coronary artery bypass grafting (CABG) were enrolled in this prospective study. Polyvascular disease was defined on the presence of existing symptomatic or asymptomatic carotid artery stenosis and/or peripheral artery disease, which is present in 32.1% of patients (n=151).
  
  
  RESULTS
  Clinical and laboratory features independently associated with the presence of polyvascular disease included age ≥65 years, male sex, hypertension, former or current smoker, low BMI, and high Lp(a). Lp(a) was the only biochemical marker that had an independent association with polyvascular disease (OR=1.01 per 1mg/dl increase; 95% CI, 1.00-1.01). The fourth quartile of Lp(a) has significant associations with the risk of two or more vascular territories involvement (OR=1.866; 95% CI, 1.056-3.297), and three vascular territories involvement (OR=4.240; 95% CI, 1.405-12.798). There was a significant trend towards patients with the highest quartile of Lp(a) that has association with more advanced polyvascular disease (test for trend: p=0.008 for involvement of three vascular territories).
  
  
  CONCLUSIONS
  High Lp(a) was independently associated with polyvascular disease in patients who undergo CABG, which is suggestive of an indirect evidence of the pathophysiologic function of Lp(a) in polyvascular disease.
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Pamela
authors.initials: P
authors.lastname: Song
authors.forename: Jin Myoung
authors.initials: JM
authors.lastname: Seok
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Kim
authors.forename: Young Tak
authors.initials: YT
authors.lastname: Lee
authors.forename: Duk-Kyung
authors.initials: DK
authors.lastname: Kim
authors.forename: Gyeong-Moon
authors.initials: GM
authors.lastname: Kim
mesh_terms: D000367:Age Factors; D000368:Aged; D016893:Carotid Stenosis / Q000150:complications*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications*; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D017270:Lipoprotein(a)