Lipoprotein(a) level and apolipoprotein(a) phenotype as predictors of long-term cardiovascular outcomes after coronary artery bypass grafting

An elevated lipoprotein(a) plasma level as a cardiovascular risk factor

“…300 mg/L aged in average 56.3 years [20]. The Lp(a) plasma level of 530 mg/L was identified as a threshold for occurring of symptomatic peripheral arterial disease [31].…”

“…Several trials have demonstrated a sudden change of odds ratios for cardiovascular events at Lp(a) plasma concentrations of more than 200e300 mg/L [15,19,20]; other observations pointed to a continuous increase in risk with no evidence of a threshold [12,21].…”

“…The data from the basic research on an active role of Lp(a) in proliferation of vascular smooth muscle cells, inhibition of plasminogen binding to the surfaces of endothelial cells, accumulation in the vascular wall in atherosclerotic lesions, acute inflammation promoting the enhancement of intercellular adhesion molecules shed light on the mechanisms of atherogenic effects of this specific lipoprotein and apo(a) [4,19,20,22,23].…”

Lowering of lipoprotein(a) level under niacin treatment is dependent on apolipoprotein(a) phenotype

“…Lp(a) concentration was estimated by ELISA using monospecific polyclonal sheep anti-human-apo(a) antibodies as previously reported [9]. Apo(a) phenotyping was performed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of plasma under reducing conditions followed by immunoblotting with the use of affinity-purified antibodies against Lp(a).…”

Role of Lipoprotein Apheresis in Cardiovascular Disease Risk Reduction

“…One study assessed longterm (15 year) cardiovascular outcomes in patients who had undergone coronary artery bypass grafting, and indicated Lp(a) levels were an independent risk factor, causing a 3-fold increase in risk of major cardiovascular events [64]. Lastly, Lp(a) levels are implicated in noncoronary types of CVD, including stroke [65], peripheral arteriosclerosis [66] and aortic valve stenosis [67,68].…”