RELATION OF PLASMA LIPOPROTEIN(A) TO INFARCT ARTERY PATENCY IN SURVIVORS OF MYOCARDIAL-INFARCTION

被引:76
作者
MOLITERNO, DJ
LANGE, RA
MEIDELL, RS
WILLARD, JE
LEFFERT, CC
GERARD, RD
BOERWINKLE, E
HOBBS, HH
HILLIS, LD
机构
[1] UNIV TEXAS, SW MED CTR,DEPT INTERNAL MED,ROOM CS7102, 5323 HARRY HINES BLVD, DALLAS, TX 75235 USA
[2] PARKLAND MEM HOSP & AFFILIATED INST, CARDIAC CATHETERIZAT LAB, DALLAS, TX USA
[3] UNIV TEXAS, SW MED CTR, DEPT MOLEC GENET, DALLAS, TX 75235 USA
[4] UNIV TEXAS, SW MED CTR, DEPT BIOCHEM, DALLAS, TX 75235 USA
[5] UNIV TEXAS, HLTH SCI CTR, CTR DEMOG & POPULAT GENET, HOUSTON, TX 77225 USA
关键词
FIBRINOLYSIS; THROMBOLYSIS; APOLIPOPROTEINS;
D O I
10.1161/01.CIR.88.3.935
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. In the minutes to days after myocardial infarction, endogenous lysis of an occlusive coronary arterial thrombus occurs in most subjects. Compared with those in whom thrombolysis does not occur, those with antegrade flow in the infarct artery have improved left ventricular performance, less left ventricular dilatation, and improved survival. This study was performed to assess intrinsic hemostasis and fibrinolysis in survivors of myocardial infarction with or without antegrade perfusion of the infarct artery. Methods and Results. In 105 survivors of infarction (75 men, 30 women; age, 30 to 80 years) not given thrombolytic therapy, coronary angiography revealed a patent (group 1, n=52) or occluded (group 2, n=53) infarct artery. Plasma concentrations of plasminogen, fibrinogen, tissue plasminogen activator activity, plasminogen activator inhibitor activity, cholesterol, triglycerides, and lipoproteins, including lipoprotein(a) (Lp[a]), were measured in blood procured 23+/-13 (mean+/-SD) months after infarction. Groups 1 and 2 were similar in age, sex, race, cardioactive medications, infarct artery, extent of coronary artery disease, and left ventricular performance. Of the plasma constituents assayed, the groups were similar except that Lp(a) averaged 18.5+/-21.7 mg/dL in group 1 and 49.1+/-44.8 mg/dL in group 2 (P<.001). This difference was evident in both Caucasian (n=65) (P=.009) and African American (n=40) (P=.01) subjects. Conclusions. Survivors of myocardial infarction who failed to recanalize the infarct artery have higher plasma Lp(a) concentrations than those with a patent infarct artery. Lp(a) may inhibit intrinsic fibrinolysis.
引用
收藏
页码:935 / 940
页数:6
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