© 1996 American Heart Association, Inc.
Articles |
Plasma Lipoprotein(a) Levels in Subjects Attending a Metabolic Ward
Discrimination Between Individuals With and Without a History of IschemicStroke
Presented in part at the XIV Congress of the International Society on Thrombosis and Haemostasis, New York, NY, July 4-9, 1993, and published in abstract form (Thromb Haemost. 1993; 69:820).
From the Clinica Medica (G.D.M., E.C., A.P., S.P., M. Mancini), Istituto di Medicina Interna e Malattie Dismetaboliche; the Dipartimento di Biochimica e Biotecnologie Mediche (F.P.M.), Universita' di Napoli; and Unita' di Trombosi e Aterosclerosi (M. Margaglione, G.D.M., E.G., G.V., G.C., M.G.), Istituto Ricovero Cura Carattere Scientifico, "Casa Sollievo della Sofferenza," S. Giovanni Rotondo, Italy.
Correspondence to Giovanni DiMinno, MD, Clinica Medica, Istituto di Medicina Interna e Malattie Dismetaboliche, Via S Pansini, 5, 80131, Napoli, Italy.
Abstract In this cross-sectional study we compared the
abilities of lipoprotein(a) [Lp(a)], plasminogen
activator inhibitor–1 (PAI-1), and tissue
plasminogen activator (TPA) to discriminate
between individuals with and without a history of stroke from among
subjects in a metabolic ward. A total of 210 subjects (108
men and 102 women; mean age, 63.8 years; range, 31 to 86 years)
provided plasma and DNA samples for the study. Of these, 51 men and 50
women had a history of ischemic stroke. The 109 subjects
without a history of stroke were compared with those with such a
history for major risk factors for ischemic events. Mean plasma
TPA and PAI-1 levels significantly (P<.001) discriminated
among subjects younger than 70 years with a history of stroke. The mean
plasma Lp(a) level of stroke subjects (21.9 mg/dL) did not differ
significantly from that of control subjects (15.2 mg/dL). However,
among individuals <70 years old, Lp(a) plasma levels >50 mg/dL were
more common among stroke patients (8 with versus 1 without,
P<.01 by 
2 test). A molecular
variation in the 5' flanking region of the apo(a) gene that has been
related to elevated Lp(a) plasma levels (G/A-914) was not strongly
correlated with circulating levels of Lp(a), nor did Lp(a) levels
correlate with a polymorphism of the apo(a) gene (G/A-21), which is
strongly linked (P<.001) to the G/A-914 variation. In this
setting, the relation between Lp(a) and cerebral ischemia
appears to be limited to individuals below 70 years with elevated (>50
mg/dL) plasma levels of the lipoprotein.
Key Words: lipoprotein(a) • genotype • fibrinolytic variables • ischemic stroke
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