• 作者：Teresa Arrobas^a ; ^{teretuki76@hotmail.com} ; Antonio Barco^a ; Miguel Á ; ngel Rico^b ; Reyes de la Iglesia^b ; Ana Isabel Oribe^a ; Carmen Cruz^a ; Fernando Fabiani^a
• 关键词：Lipoprote&iacute ; nas ; Lipoprote&iacute ; na (a) ; Colesterol unido a lipoprote&iacute ; nas de alta densidad ; Colesterol unido a lipoprote&iacute ; nas de baja densidad ; Riesgo cardiovascular ; Objetivo terapé ; utico
• 刊名：Cl铆nica e Investigaci贸n en Arteriosclerosis
• 出版年：2010
• 期刊代码：pca88_02149168
• 类别：med
• 出版时间：January-February 2010
• 卷：22
• 期：1
• 页码：7-14
• 文件大小：310 K

Lipoprotein(a) (Lp[a]) is a spherical lipoprotein, rich in cholesterol esters and phospholipids, with an apolipoprotein structurally similar to the LDL molecule. Elevated LP(a) levels are associated with heart attacks, stroke, narrowing of the arteries and restenosis of vessels after coronary bypass surgery. Lp(a) concentrations cannot be modified by routine lipid-lowering therapy and consequently this lipoprotein will influence the achievement of therapeutic targets. The proportion of cholesterol carried by Lp(a) is unchangeable and can reach concentrations of up to 80-90 mg / dl.

Objectives

To study the influence of Lp(a) levels on the achievement of therapeutic LDL-cholesterol targets in high cardiovascular risk patients and to analyze the possible alternatives.

Patients and methods

We selected a population of 100 patients undergoing aortocoronary bypass. In all patients, weight, height, blood pressure and waist perimeter were measured. Hemogram, coagulation parameters, thyroid profile, general biochemistry and cardiovascular risk profile were also determined.

Results

Patients were divided according to Lp(a) concentrations at 1 year of follow-up. According to Lp(a) values, therapeutic LDL-cholesterol targets were achieved by 46.55%of patients with Lp(a) < 30 mg/dl and by 35.71%of those with Lp(a) > 30 mg/dl. When corrected LDL (LDL-c - Lp(a)-c) was applied, achievement of therapeutic targets increased by 39.89%in the group at highest risk, representing 75.60%of this group.

Conclusions

We confirm that reaching therapeutic LDL-cholesterol targets can be improved by more intensive follow-up. Achievement of targets is influenced by rising concentrations of Lp(a), confirming that targets are harder to achieve in patients whose Lp(a) profile confers higher risk.