[Lipoprotein (a), D-Dimer and apolipoprotein A1 as markers of presence and severity of coronary disease].

BACKGROUND AND OBJECTIVE: To examine the relationship between blood levels of lipids as well as haemostatic and inflammatory markers and the presence and severity of angiographically-evaluated coronary stenosis.

MATERIAL AND METHOD: We included 897 patients (629 males and 268 females), aged 65.12+/-11.23 years, who were admitted to the hospital presenting an acute episode or to discard coronary heart disease. Each patient underwent coronariography using the Seldinger technique. Blood samples were drawn to analyze lipid [total cholesterol, HDLcholesterol, triglycerides, LDLcholesterol, apolipoprotein A1, apolipoprotein B100, lipoprotein (a)], haemostatic (fibrinogen, D-Dimer, tissue factor and tissue factor pathway inhibitor), and inflammatory (C-reactive protein, leukocyte count) markers.

RESULTS: Six hundred and fifty nine patients presented coronary stenosis and 238 were considered as controls. Patients with coronary stenosis presented higher values of lipoprotein (a), D-Dimer, C-reactive protein and leukocyte count and lower concentrations of HDLcholesterol, apolipoprotein A1 and total cholesterol than controls. In a multivariate analysis, sex (OR 2,692; IC95% 1,822-3,979), dislypemia (OR 2,241; IC95% 1,559-3,221), arterial hypertension (OR 1,623; IC95% 1,116-2,359), diabetes (OR 1,608; IC95%1,054-2,451), leukocyte count (OR 1,181; IC95% 1,082-1,288), lipoprotein (a) (OR 1,205 IC95% 1,079-1,346), D-dimer (OR 1,468 IC95% 1,152-1,871) and apolipoprotein A1 (OR 0,992 IC95% 0,985-0,999) were independent risk factors of coronary obstruction. Only lipoprotein (a) and D-dimer levels increased according to the severity of obstruction whereas apolipoproteín A1 and HDl cholesterol diminished.

CONCLUSIONS: Our results suggest that lipoprotein (a), D-dimer and apolipoproteín A1 are significantly associated with the presence and severity of coronary stenosis.