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. 2015 Jul 7;2015(2):28.
doi: 10.5339/gcsp.2015.28. eCollection 2015.

High prevalence of raised lipoprotein(a) in patients with refractory angina

Tina Z Khan  1 , Samantha Rhodes  1 , Alison Pottle  1 , Winston Banya  2 , Robert Smith  1 , Tito Kabir  1 , Charles Ilsley  1 , Dudley J Pennell  2 , Mahmoud Barbir  1
Affiliations

High prevalence of raised lipoprotein(a) in patients with refractory angina

Tina Z Khan et al. Glob Cardiol Sci Pract. .

Abstract

Background: Angina that is refractory to conventional medical therapy and revascularisation, remains challenging to manage and poses significant burden to patients. Elevated lipoprotein(a) [Lp(a)] has emerged as an important independent cardiovascular risk factor and predictor of adverse outcomes in atherosclerotic disease. The prevalence of raised Lp(a) amongst patients with refractory angina has not yet been defined.

Objective: To establish the prevalence of raised [Lp(a)] >500 mg/L in patients with refractory angina.

Methods: We conducted an epidemiological screening pilot study in 75 patients with refractory angina from a UK tertiary cardiac centre. We determined the proportion of the cohort with raised Lp(a) >500 mg/L using an isoform-insensitive method. In addition, a full fasting lipid profile (including: LDL cholesterol, HDL cholesterol, total cholesterol to HDL ratio and triglycerides) was obtained. Patients were also asked about the presence of conventional cardiovascular risk factors.

Results: Our study demonstrated that 60% of the 75 patients with refractory angina had raised Lp(a) levels of >500 mg/L. The median and inter-quartile range of Lp(a) values were 771 mg/L (162 mg/L,1260 mg/L) respectively.

Conclusions: This high prevalence of raised Lp(a) detected in our cohort with refractory angina may suggest a causal role. Further research is necessary to confirm this association and prospective studies are needed to explore the potential therapeutic benefit of Lp(a) reduction in patients with refractory angina.

Keywords: Coronary artery disease; Lipoprotein (a); Refractory angina; Risk factors.

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Figures

Figure 1.
Figure 1.
Percentage of patients with refractory angina with Lp(a) >500 mg/L. Total patients = 75.
Figure 2a.
Figure 2a.
Distribution of Lp(a) values.
Figure 2b.
Figure 2b.
Distribution of LDL cholesterol values.
Figure 2c.
Figure 2c.
Distribution of Triglyceride values.
See this image and copyright information in PMC

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