정상 혈청 콜레스테롤치를 갖는 관동맥 질환 환자에서 혈청 Lipoprotein ( a ) 의 임상적 의의 = Clinical Significance of Lipoprotein ( a ) in Coronary Artery Disease Patients with Normal Cholesterol Level

다국어 초록 (Multilingual Abstract)

Background: Although serum lipids and lipoproteins are well known risk factors for coronary artery disease (CAD), many Korean patients with CAD do not have elevated serum cholesterol level. This study is attempted to elucidate the contribution of serum lipoprotein (a)[Lp (a)) levels to CAD.
Methods: To evaluate the clinical significance of serum Lp(a) levels in the presence and severity of CAD, especially in patients with normal serum cholesterol level, lipid profiles and Lp(a) levels were measured in 38 controls and 97 patients with CAD documented by coronary angiogram. We quantified serum Lp(a) level by ELISA procedure. The severity of CAD was semi-quantified by a coronary atherosclerosis score (CAS) system based on the number and degree of stenosis of lesions in 8 segments of coronary artery.
Results:
1) The variables which show significant differences between the control and the patient group are total cholesterol, triglyceride, LDL cholesterol, apo A-I, apo B, and Lp(a).
2) Total cholesterol, LDL cholesterol, apo A-I, apo B, and Lp(a) are significant risk factors for CAD. With use of multiple regression analysis, Lp(a) level is independently associated with presence of CAD.
3) Especially in normocholesterolemic group (total cholesterol$lt;200㎎/㎗, Lp(a) and apo A-I are risk factors for CAD. With use of multiple regression analysis, Lp(a) is very powerful indicator for the presence of CAD (p=0.01).
4) Serum Lp(a) level is well correlated with the severity of coronary atherosclerosis.
Conclusion: These data suggest that increased serum Lp(a) level is an independent risk factor for coronary artery disease, especially in normocholesterolemic group (total cholesterol $lt; 200 ㎎/㎗), and Lp(a) level is significantly associated with the severity of coronary atherosclerosis.