Elevated serum lipoprotein(a) level is an independent marker of severity of thoracic aortic atherosclerosis

Study objective: Lipoprotein(a) (Lp[a]) level is a risk factor for ischemic heart disease, cerebrovascular disease, and peripheral vascular disease. However, few data are available concerning the relationship between Lp(a) level and severity of thoracic aortic atherosclerosis. We hypothesized in this transesophageal echocardiography (TEE) study that Lp(a) level is a marker of severity of thoracic aortic atherosclerosis. Design: Cross-sectional study. Setting: University hospital. Patients: Risk factors, coronary angiographic features, and TEE findings were analyzed prospectively in 119 patients with valvular disease. Measurements and results: The following risk factors were recorded: age, gender, hypertension, smoking, lipid parameters, diabetes, body mass index, and family history of coronary artery disease. Serum levels of Lp(a) were measured for each patient. By univariate analysis, age, diabetes, hypertension, smoking, Lp(a), total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels were significant predictors of thoracic aortic atherosclerosis. There was a positive and significant correlation between the Lp(a) levels and the score of severity of thoracic aortic atherosclerosis (p = 0.0001). Multivariate regression analysis revealed that Lp(a) was an independent predictor of severity of thoracic aortic atherosclerosis (p = 0.0001). Conclusion: This prospective study indicates that serum Lp(a) level is an independent marker of severity of thoracic aortic atherosclerosis detected by multiplane TEE. These findings emphasize the role of Lp(a) as a marker of atherosclerotic lesions in the major arterial locations.