Lipoprotein(a) Is Associated Differentially With Carotid Stenosis, Occlusion, and Total Plaque Area
- 1 October 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Arteriosclerosis, Thrombosis, and Vascular Biology
- Vol. 28 (10), 1851-1856
- https://doi.org/10.1161/atvbaha.108.169292
Abstract
Background— Lipoprotein(a) [Lp(a)] is a putative risk factor for myocardial infarction and stroke and is related to thrombosis and impaired fibrinolysis. We studied relationships of Lp(a) with carotid stenosis, occlusion, and total plaque area, distinct phenotypes of atherosclerosis that may be differentially affected by cardiovascular risk factors. Methods and Results— Multivariable linear regression analysis was used to study relationships of Lp(a) to phenotypes of carotid atherosclerosis among 876 consecutive patients from an atherosclerosis prevention clinic with complete data for all variables used in the model. Occlusion of an internal carotid artery was present in 22 (2.5%) patients (one with bilateral occlusions). Risk factors predicted carotid plaque area, stenosis, and occlusion differently. Lp(a) was a significant independent predictor of baseline stenosis ( P P =0.13); in logistic regression, Lp(a) significantly predicted occlusion ( P =0.001). Patients with occlusion had significantly higher levels of Lp(a): 0.27±0.25 g/L versus 0.17±0.18 g/L without occlusion; P =0.007. Conclusion— Lp(a) was a significant independent predictor of carotid stenosis and occlusion, but not of carotid plaque area, supporting the hypothesis that the effect of Lp(a) on atherogenesis and cardiovascular risk is largely related to thrombosis and impaired fibrinolysis. Stenosis and occlusion may not be attributable to plaque progression, but to plaque rupture and thrombosis; this relationship may also apply to other arterial beds.Keywords
This publication has 17 references indexed in Scilit:
- Lipoprotein(a) and Incident Ischemic StrokeStroke, 2006
- Antagonism of the prostaglandin D 2 receptor 1 suppresses nicotinic acid-induced vasodilation in mice and humansProceedings of the National Academy of Sciences, 2006
- Noninvasive Phenotypes of AtherosclerosisArteriosclerosis, Thrombosis, and Vascular Biology, 2004
- Sex Differences in Carotid Plaque and StenosisStroke, 2004
- Relationship Between Blood Pressure and Stroke Risk in Patients With Symptomatic Carotid Occlusive DiseaseStroke, 2003
- Mineral Exploration: Search for the Mechanism of Vascular Calcification and BeyondArteriosclerosis, Thrombosis, and Vascular Biology, 2003
- Carotid Plaque AreaStroke, 2002
- The genetic basis of atherosclerosisInternational Journal of Clinical and Laboratory Research, 1997
- Psychological stress and the progression of carotid artery diseaseJournal Of Hypertension, 1997
- Compensatory Enlargement of Human Atherosclerotic Coronary ArteriesNew England Journal of Medicine, 1987