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KMID : 0880520100460010038
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Chonnam Medical Journal
2010 Volume.46 No. 1 p.38 ~ p.43
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The Relationship between the Levels of Lipoprotein (a) and Fibrinogen and Clinical Outcome in Patients with Acute Myocardial Infarction
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Kim Su-Hyun
Jeong Myung-Ho
Lee Min-Goo
Ko Jum-Suk
Park Keun-Ho
Sim Doo-Sun
Hong Young-Joon
Kim Ju-Han
Ahn Young-Keun
Kang Jung-Chaee
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Abstract
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The aim of this study was to evaluate clinical outcomes in patients with acute myocardial infarction (AMI) on the basis of serum levels of lipoprotein (a) [Lp(a)] and fibrinogen. A total of 537 consecutive patients (62.4±12.3 years) diagnosed with AMI between January 2006 and December 2007 were divided into four groups according to serum levels of Lp(a) and fibrinogen on admission [group I: normal Lp(a) and normal fibrinogen levels (n=235); group II: elevated Lp(a) and normal fibrinogen levels (n=100); group III: normal Lp(a) and elevated fibrinogen levels (n=105); group IV: elevated Lp(a) and elevated fibrinogen levels (n=95)]. The baseline clinical characteristics showed significant differences between the four groups in age (p<0.001), body mass index (p=0.025), N-terminal pro-brain natriuretic peptide levels (p<0.001), left ventricular ejection fraction (p<0.001), and echocardiographic wall motion scores (p<0.001). In the coronary angiographic findings, the number of diseased vessels was higher?and involvement of the left anterior descending artery was more common in group IV than in group I (1.8±0.9 vs. 1.5±0.8, p=0.001, and 65% vs. 51%, p=0.042, respectively). Likewise, in-hospital and 1-month major adverse cardiac events were more frequent in group IV than in group I (4.2% vs. 1.3%, p=0.037, and 14.1% vs. 3.1%, p<0.001, respectively). In conclusion, AMI patients with high Lp(a) or fibrinogen levels had worse clinical outcomes than did patients with normal levels of Lp(a) and fibrinogen.
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KEYWORD
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Lipoproteins, Fibrinogen, Prognosis
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