Abstract
Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerosis in the general population and represents a greater risk to hemodialysis patients (HD patients). Because the relationship between risk factors attributed to atherosclerosis for ischemic heart disease (IHD) and Lp(a) has not been established, we compared levels of Lp(a) and the frequency of occurrence of its isoforms in 317 patients and 212 normal subjects. We used thallium-201 single photon emission computed tomography for the assessment of IHD. The following results were obtained: 1) HD patients showed significantly elevated levels of Lp(a) when compared with normal subjects. There were no significant differences in the levels of Lp(a) occurring in other etiological diseases. 2) Studies of the apo(a) isoform showed that HD patients had high frequencies of S2 and S2/S3. 3) No significant differences were observed between the levels of Lp(a) and the apo(a) isoform in IHD(-) and IHD(+) in HD patients. The abnormal characteristics of lipid metabolism found in HD patients who died from IHD were high levels of Lp(a), LDL-cholesterol and high double band frequencies.
These results indicate that Lp(a) may represent a risk factor for IHD in HD patients.
