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The Journal of Cardiovascular Surgery 2002 December;43(6):811-5

lingua: Inglese

Course of serum lipoprotein(a) and acute phase protein levels in patients undergoing open heart surgery

Kaklikkaya I. 1, Özdemir R. 1, Örem A. 2, Ünal M. 3, Sönmez B. 3, Özcan F. 1

1 Karad­eniz Tech­nical Uni­ver­sity, Faculty of Med­i­cine, Depart­ments of Tho­racic and Car­di­o­vas­cular Sur­gery,
2 Bio­chem­istry, ­Trabzon,
3 Flor­ance Night­in­gale Hos­pital, ­Istanbul, ­Turkey


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Back­ground. Lip­o­pro­tein(a) [Lp(a)] is an impor­tant ­risk ­factor in the path­o­gen­esis of cor­o­nary ­artery dis­ease ­because of its throm­bo­genic and ather­o­genic prop­er­ties. Lp(a) ­also dis­plays ­another prop­erty by ­acting as an ­acute ­phase reac­tant.
­Methods. In ­this ­work, the ­study ­group con­sisted of 20 ­male ­patients ­having cor­o­nary ­artery ­bypass ­under car­di­o­pul­mo­nary ­bypass (CPB). Pre­op­er­a­tive and post­op­er­a­tive ­levels of ­plasma ­total cho­les­terol, tri­gly­ce­ride, apo­lip­o­pro­tein A1 (Apo A1), apo­lip­o­pro­tein B (Apo B), α-1 anti­trypsin (α1-AT), ­α-2 mac­ro­glob­ulin (α2-MG), ­α-1 ­acid gly­co­pro­tein (α1-AG), Lp(a) ­were meas­ured in all ­patients one day ­before and ­after the 1st, 2nd, 4th, and 10th ­days of CPB.
­Results. It was ­observed ­that the ­levels of Lp(a) ­levels grad­u­ally ­reached the pre­op­er­a­tive ­levels at the 10th post­op­er­a­tive day ­period. ­Observed ­change of the Lp(a) ­levels was sim­ilar to ­that of the ­other ­acute ­phase pro­teins ­which are syn­the­sized and ­released ­from ­liver. In con­trast, α2-MG has ­shown dif­ferent beha­viour in ­terms of oper­a­tive ­values. The ­changes ­observed for all ­these ­3 param­e­ters ­were ­found to be sta­tis­ti­cally sig­nif­i­cant (p<0.01).
Con­clu­sions. The ­data has indi­cated ­that Lp(a) ­levels ­show sim­ilar ­progress ­with α2-MG ­levels. It can be con­cluded ­that ­serum ­levels of Lp(a) ­after cor­o­nary arte­rial ­bypass ­decrease ­depending ­upon sev­eral fac­tors and ­reach ­basal ­levels at the end of a 10 day-­period of post­op­er­a­tion. The ­main ­cause for ­this ­decrease ­might ­result ­from the con­tact of ­blood ­with for­eign sur­faces of the ­heart-­lung ­machine.

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