Lipoprotein(a) is associated with thrombus burden in culprit arteries of younger patients with ST-segment elevation myocardial infarction

Dipen Mayurkumar Sankhesara, Nick S R Lan, Poppy Gilfillan, Elly Zounis, Saumya Rajgopal, Dick C Chan, Jing Pang, Graham S Hillis, Gerald F Watts, Carl J Schultz

Research output: Contribution to journalArticlepeer-review

Abstract

Background Lipoprotein(a) [Lp(a)] is a risk factor for cardiovascular disease. The burden of thrombus in ST-segment elevation myocardial infarction (STEMI) has implications on treatment and outcomes. However, the association between Lp(a) and atherothrombosis in STEMI remains unclear. Objectives Determine the association between Lp(a) and culprit artery thrombus burden in younger patients with STEMI. Methods Single-centre study of 83 patients aged 30 mg/dL. Multivariate analysis was performed adjusting for cardiovascular risk factors. Results The mean age was 48.08.4 years and 78.3% were male. Thirteen (16%), 9 (11%) and 61 (73%) patients had small, moderate, or large thrombus burden, respectively, and 34 (41%) had elevated Lp(a). Elevated Lp(a) was associated with greater thrombus burden compared to normal Lp(a) (large burden 85% versus 65%; P=0.024). Elevated Lp(a) was associated with moderate or large thrombus in univariate [OR 10.70 (95% CI 1.32-86.82); P=0.026] and multivariate analysis [OR 10.33 (95% CI 1.19-89.52); P=0.034]. Lp(a) was not associated with culprit artery or stenosis location according to culprit artery. Conclusions Elevated Lp(a) is associated with greater thrombus burden in younger patients with STEMI. The finding of this observational study accords with the thrombotic and anti-fibrinolytic properties of Lp(a). A causal relationship requires verification.
Original languageEnglish
JournalCardiology: international journal of cardiovascular medicine, surgery and pathology
DOIs
Publication statusAccepted/In press - 9 Feb 2023

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