| ǥ :
|
ȣ - 520069 193 |
| High Level of Lipoprotein (a) and Fibrinogen Is Associated with Poor Clinical Outcome in Patients with Acute Myocardial Infarction |
| 전남대학교병원 심장센터, 전남대학교 심혈관계 특성화 사업단 |
| 김수현, 정명호, 강원유, 이민구, 고점석, 이신은, 박근호, 심두선, 윤남식, 윤현주, 김계훈, 박형욱, 홍영준, 김주한, 안영근, 조정관, 박종춘, 강정채 |
Background The aim of this study was to assess the clinical characteristics of acute myocardial infarction (AMI) based on lipoprotein (a) [Lp(a)] and fibrinogen level.
Methods: Between Jan 2006 to Dec 2007, we analyzed serum levels of Lp(a) and fibrinogen in 537 consecutive AMI patients (62.44±12.3 years) on admission. They were divided into four groups [Group I: normal levels of Lp(a) and fibrinogen (n=235), Group II: elevated level of Lp(a) (n=100) only, Group III: elevated level of fibrinogen (n=105), Group IV: elevated level of both Lp(a) and fibrinogen (n=95)].
Results: The baseline clinical characteristics among four groups showed significant difference in age (60.1±12.7 vs. 62.5±11.5 vs. 63.7±12.3 vs. 66.4±10.9 years, p<0.001) and BMI (24.2±3.0 vs. 24.4±2.9 vs. 24.3±3.2 vs. 23.1±3.8 kg/m2, p=0.025). In baseline clinical characteristics, there were no differences in hypertension, diabetes mellitus, dyslipidemia, smoking and family history among 4 groups. In laboratory findings, there were significant difference in triglyceride levels (129.9±97.4mg/dL vs. 102.8±48.8mg/dL vs. 119.1±74.4 mg/dL vs. 104.2±49.7mg/dL, p=0.007) and N-terminal prohormone brain natriuretic peptide (1726.2±4576.1 pg/mL vs. 1986.4±4762.6 pg/mL vs. 4442.3±7783.8pg/mL vs. 6274.2±9105.4pg/mL, p<0.001). There are significant differences in left ventricular ejection fraction (LVEF)(57.03±11.8% vs. 54.67±13.12% vs. 52.09±12.54% vs. 48.83±12.71%, p<0.001), left ventricular wall motion score (20.65±4.94 vs. 21.36±5.52 vs. 22.22±5.59 vs. 23.34±6.84, p<0.001) with ANOVA. In coronary angiography finding, we could see significant difference in involved vessel number (1.45±0.82 vs. 1.60±0.86 vs. 1.78±0.94 vs. 1.83±0.92, p=0.001), and target lesion location; LAD (Group I: 51% vs. Group IV: 65%, p=0.019), RCA (Group I: 34% vs. Group II: 51%, p=0.003, Group I: 34% vs. Group III: 46%, p=0.019). In-hospital complications, cardiogenic shock developed more frequently in Group IV (Group II: 5% vs. Group IV: 15%).
Conclusion: Baseline clinical characteristics and in-hospital outcome were poor in AMI patients with high levels of Lp (a) and/or fibrinogen compared with patients with normal levels.
|
|
|
|
|
