Directive: The aim of the study was to determine the role of Lp(a) level on left atrial thrombus
formation and plasminogen activity in patients with chronic atrial fibrillation.
Materials and Methods: Clinical, laboratory and transoesophageal echocardiographic data were
collected from fifty consecutive non anticoagulated patients with chronic atrial fibrillation. They
were divided into two groups according to Lp(a) level: Thirty patients were with Lp(a) level>
30mg/dI (group I) and twenty patients had Lp(a) level < 30mg/dI (group II).
Results: There was no significant difference in left atrial size between the two groups (5.53 vs
5.08cm) (P > 0.05). group I showed a significant decrease of left atrial appendage (LAA) flow
velocity (15.93vs 27.42cm/s) (p< 0.01) and a significant increase of spontaneous echo contrast
(SEC) (2.0 vs 0.3%) (p < 0.01) A significant increase in fibrinogen level (480.7 vs 387.55mg/dI)
(p< 0.01) and total cholesterol (193.17vs 143.3mg/dI) (P< 0.01) were observed in group I. There
was no significant difference in plasminogen activity and D-dimers level between the two groups
I & II (p > 0.05). multiple regression analysis showed a positive correlation between Lp (a) > 30
mg/c11 and high fibrinogen level. A negative correlation was observed between Lp(a)> 30mWdl
and both left atrial appendage flow velocity and plasminogen activity.
Conclusion: Elevated Lp(a) in chronic Al? patients can be considered as a predictor for left atrial
thrombus formation and thromboembolic risk. Long term anticoagulation should be considered
in those patients. |
