Lipoprotein(a): important risk factor or passing fashion?

The effect of endurance training on lipoprotein(a) [Lp(a)] levels in middle-aged males

Serum lipoprotein(a) [Lp(a)] levels were measured before and after a 12-wk program of moderate-intensity endurance training. The training program consisted of walking and/or jogging, at least three sessions.wk-1 of at least 30 min duration, at an intensity producing 60-85% HRmax reserve. Twenty-eight previously sedentary middle-aged Caucasian males matched for age, body mass, and body mass index (BMI) were randomly allocated to either an exercise (N = 17, mean age +/- SEM = 51.57 +/- 1.25 yr) or a control (N = 11, mean age +/- SEM = 50.0 +/- 1.15 yr) group. Pre- and post-training median Lp(a) levels, measured by immunoturbidimetric analysis, were not significantly different in either the exercise (pre 13.0, post 15.0 mg.dl-1) or the control subjects (pre 14.0, post 12.0 mg.dl-1) (P > 0.05). Kendall Rank correlation analysis revealed no significant relationship between the level of Lp(a) and any other variable in either group before or after training. In the exercisers, a significant increase (P < 0.05) was recorded in the estimated mean VO2max (pre 33.39 +/- 1.70, post 37.7 +/- 1.75 ml.kg-1 min-1). These data indicate that the level of Lp(a) was not influenced by a 12-wk program of moderate-intensity endurance training, and are consistent with previous reports suggesting that Lp(a) level is not altered by lifestyle factors.

Association of lipoprotein(a) with atherothrombotic events and fibrinolytic variables. A case-control study

Elevated plasma levels of lipoprotein(a) [Lp(a)] have been associated with an increased risk of cardiovascular disease. The aim of the present study was to investigate whether Lp(a) plasma levels were associated with subsequent ischemic events and with fibrinolytic variables in patients with established atherosclerotic disease enrolled in the prospective PLAT study. Lp(a) levels and fibrinolytic variables in 37 atherosclerotic patients who subsequently developed an atherothrombotic event during the first year of follow-up (cases) were compared with those in paired controls, matched for age, sex, diagnosis at enrollment and lipid pattern, who remained free from vascular events during the same time frame. Median and mean Lp(a) levels were similar in cases (6.05 mg/dl; 13.8 +/- 19.4 mg/dl) and controls (6.05 mg/dl; 17.1 +/- 21.6 mg/dl). In the whole group plasma Lp(a) levels correlated significantly with the increase of t-PA antigen (r = 0.368; p = 0.002) and fibrinolytic activity (r = 0.410; p = 0.001) induced by venous stasis but not with baseline fibrinolytic variables. These findings indicate that in patients with established atherosclerotic disease Lp(a) may interfere in vivo with the fibrinolytic process but is not predictive of subsequent ischemic events.