Changes in lipoprotein(a) concentrations in patients with acute coronary syndrome.

Introduction: Recently, interest has been growing in lipoprotein(a) (Lp(a)) as an independent risk factor for cardiovascular diseases. European Society of Cardiology (ESC) recommends a single measurement of Lp(a) concentration as a guide to determining cardiovascular risk group and appropriate treatment. Although initially assumed to be genetically determined, a growing number of reports indicate that Lp(a) concentration may change over time.

Objectives: The aim of the study was to compare changes in the concentration of Lp(a) in ACS patients at the moment of ACS and three months later.

Patients and methods: Forty patients with acute coronary syndrome (ACS) were enrolled and divided into ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI)+ unstable angina (UA) groups. The lipid, CRP, hs-TnT, NT-proBNP and Lp(a) levels were determined in these patients using routine laboratory methods, with IL-33 levels measured using ELISA.

Results: Among all ACS patients, 9 out of 40 (22.5%) had elevated Lp(a) levels (>75 nmol/L); this proportion was higher in STEMI (n = 8; 35%) compared to NSTEMI+UA (n = 2; 13%). All patients with ACS demonstrated significantly higher Lp(a) serum levels three months after ACS. The Lp(a) level at the moment of ACS and three months later differed significantly with those among STEMI patients (P = 0.03), all patients with ACS (P = 0.003) and NSTEMI+UA (P = 0.003).

Conclusion: Measuring Lp(a) level during ACS may be insufficient for accurate diagnosis and effective treatment, as its concentration increases after three months. Therefore, ACS may be regarded as another non-genetic factor influencing Lp(a) concentration.