Lipoprotein(a) levels in patients with unstable angina and their relationship with atherothrombosis and myocardial damage.

The aim of the study was to compare lipoprotein(a) [Lp(a)] levels in patients with cTroponin-I (cTn-I)-positive or -negative unstable angina and to investigate their relationship with atherothrombosis. A total of 202 consecutive patients were enrolled in the study. Lp(a), fibrinogen, plasminogen, PAI-1 and t-PA levels were measured and C-reactive protein (CRP) assays were performed on admission for all patients, and venous blood samples were drawn 12 and 24 h later for cTn-I measurements. The patients were divided into cTn-I-negative (cTn-I < 1 ng/ml) and -positive (cTn-I > or = 1 ng/ml) unstable angina groups. Lp(a) levels of the cTn-I-positive patients were higher than those of the cTn-I-negative patients (52.9 +/- 6.0 and 15.7 +/- 2.5 mg/dl, p < 0.0001). There was a positive correlation between Lp(a) and cTn-I levels (r = 0.692; p = 0.0001). Increase in coagulation activity and impairment in fibrinolytic activity were significant in the cTn-I-positive patients. Elevated Lp(a) levels may have a role in the development of myocardial damage in patients with unstable angina.