Objectives: Evaluation of the performance of estimated serum levels of lipoprotein(a) [Lp(a)] and tissue
plasminogen activator (t-PA) in the discrimination between patients presenting by cardiac events.
Patients & Methods: 314 patients presenting with a clinical picture suggestive of an acute cardiac event
(ACE) underwent clinical and laboratory workup according to the 2017 ESC Guidelines for the
management of acute myocardial infarction (AMI). Blood samples were obtained for ELISA estimation
of serum Lp(a) and plasma t-PA levels.
Results: Clinically, 247 patients had angina; 166 stable angina (SA) and 81 unstable angina (UA), and
67 patients had AMI; 44 had non-ST-elevation MI (NSTEMI) and 23 patients had STEMI. Serum levels
of Lp(a) were significantly higher in total patients' samples especially UA and MI patients than control
samples, but were lower in SA than other patients' samples. Further, Lp(a) levels were significantly
higher in MI than UA patients' samples. Estimated t-PA levels were significantly higher in patients' than
control samples, but were significantly higher in MI than angina patients' samples. Statistical analyses
defined high estimated levels of Lp(a), t-PA, total cholesterol, and obesity as the significant
differentiating variables between SA and UA patients and defined high levels of LP(a), t-PA, and obesity,
and age as the significant predictors for NSTEMI.
Conclusion: Elevated serum levels of Lp(a) might differentiate between UA patients and SA and
NSTEMI with high specificity. |
