Relationship between lipoprotein(a) and spontaneous recanalization of infarct-related arteries in the early phase of acute myocardial infarction

Background: Lipoprotein(a)(Lp[a]) is known to inhibit the fibrinolysis system and promote thrombus formation. Hypothesis: We retrospectively investigated the influences of Lp(a) on infarct-related artery patency in the early phase of acute myocardial infarction (AMI). Methods: In 144 patients with ST-segment elevation, myocardial, coronary angiography (CAG) was performed within 12 h of the onset of symptoms. Subjects were divided into 2 groups according to the thrombolysis in myocardial infaction (TIMI) grade, Group I (TIMI 0-1, n = 94) versus Group II (TIMI 2-3, n = 50). The Gensini score and 0- to 3-vessel disease score estimated the severity and extent of coronary artery disease (CAD), respectively. Lp(a), lipid profile and c-reactive protein (CRP) were measured before any medications including thrombolytics were given. Results: The Lp(a) level was higher in Group I than in Group II. There was a weak correlation between Lp(a) level and Gensini score. By multivariate logistic regression analysis, a Lp(a) level was a predictor of infarct-related artery patency in the early phase of AMI. There were no significant differences in the location of the infarct-related arteries, extent of CAD, time from pain to CAG, number of risk factors, and hs-CRP values between the 2 groups. Conclusion: The Lp(a) level was significantly higher in patients with persistent occlusion compared with those with spontaneous recanalization of infarct-related arteries in the early phase of AMI.