The Effect of Lipoprotein(a) to Thrombolytic Therapy and Spontaneous Reperfusion in Acute Myocardial Infarction: a comparative study

Although lipoprotein-(a) [Lp(a)] is a known risk factor in acute myocardial infarction (Ml), no sufficient data are available on the question is affected by Lp(a) levels the outcome of patients undergoing thrombolytic therapy (TT). The aim of this study was to evaluate the role of serum Lp(a) levels on the outcome of the infarct-related artery in the use of TT following acute MI. 78 patients were randomly allocated into 3 groups. Group A consisted of 18 patients who received 1.5 million lU streptokinase (intravenously), Group B; 38 cases receiving 100 mg t-PA totally (intravenously) and Group C; 22 cases who did not receive any TT as a control group. All cases had undergone coronary angiography in the first 7 days and the degree of TIMI flow was determined in the infarct-related artery with TIMI-0 and I being considered as unsuccessful perfusion, whereas TIMI-Il and III as successful. Lp(a) level ? 30 mg/dl was considered as high Lp(a) level. No significant difference was found between Group A and B patients, in cases with high or low Lp(a) levels in respect to patency rates (p>0,05 for both). In Group C however, patency rate had been found significantly higher in cases with high Lp(a) level compared to cases with low Lp(a) (p<0,01) Lp(a) level in Group C patients were similar with Group A and B (p>0.05). The time interval from acute MI to coronary angiography was similar in all groups (p>0.05 for all).
CONCLUSION
Lp(a) level in cases with MI does not affect the reperfusion outcome of parenteral thrombolytic agents. However, in MI patients without use of parenteral TT, spontaneous reperfusion rate was found significantly higher in cases with low Lp(a) level compared to those with high Lp(a) level.