The immediate effect of streptokinase on serum lipoprotein(a) concentration and the effect of myocardial infarction on serum lipoprotein(a), apolipoproteins A1 and B, lipids and C-reactive protein

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      Lipoprotein(a) (Lp(a)) has close structural homology with plasminogen and, at least in vitro, may interfere with fibrinolysis. Any changes in the serum Lp(a) concentration during and following myocardial infarction (MI) and whether the serum Lp(a) level is affected by streptokinase (SK) are therefore of interest. Serum Lp(a) levels immediately before and 3 h after completion of an intravenous infusion of SK in 39 patients with acute MI were not significantly different (median 31.3 mg/dl before and 35.9 mg/dl after). Furthermore, SK added during the serum Lp(a) assay did not affect the result, except at very high concentrations of SK (1000 units/ml). Serum Lp(a) and fasting lipids were measured daily for 3 days following definite MI in 13 patients and then after 14 and 42 days. There was no significant change in serum Lp(a) following MI. In marked contrast, Greactive protein levels in these patients increased steeply immediately following MI. Thus, there was no early 'acute-phase response' in serum Lp(a) levels after MI. However, greater variation in its concentration was observed at day 14 than at other times. Serum cholesterol, apolipoprotein B and apolipoprotein Al concentrations decreased significantly following MI, whereas a significant transient increase in serum triglycerides occurred. Forty-two days after MI all lipid and lipoprotein values had regained their day 1 levels, except for apo A1, which remained depressed.


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        • Rossouw J.
        • Lewis B.
        • Rifkind B.M.
        The value of lowering cholesterol after myocardial infarction.
        N. Engl. J. Med. 1990; 323: 1112
        • Durrington P.N.
        Hyperlipidaemia, Diagnosis and Management.
        in: Wright, London1989: 71
        • Avogaro P.
        • Bitolo Bon G.
        • Cazzolato G.
        • Quici G.B.
        • Sanson A.
        • Sparla M.
        • Zagatti G.C
        • Caturelli G.
        Variations in apolipoproteins B and A, during the course of myocardial infarction.
        Eur. J. Clin. Invest. 1978; 83: 121
        • Ahnve S.
        • Angelin B.
        • Edhag O.
        • Berglund L.
        Early determination of serum lipids and apolipoproteins in acute myocardial infarction: possibility for immediate intervention.
        J. Intern. Med. 1989; 226: 297
        • Shepherd M.D.S.
        • Hester J.
        • Walmsley R.N.
        • White G.H.
        Variation in plasma apolipoprotein Al and B concentrations following myocardial infarction.
        Ann. Clin. Biochem. 1990; 27: 9
        • McLean J.W.
        • Tomlinson J.E.
        • Huang W-J.
        • Eaton D.L.
        • Cher E.Y.
        • Fless G.M.
        • Scanu A.M.
        • Lawn R.M.
        cDNA sequence of human apolipoprotein (a) is homologous to plasminogen.
        Nature. 1987; 300: 132
        • Hajjar R.L.
        Lipoprotein (a) modulation of endothelial cell surface fibrinolsis and its potential role in atherosclerosis.
        Nature. 1989; 339: 303
        • Dahlen G.
        • Berg H.
        • Gillnas T.
        • Ericson C.
        Lp(a) lipoprotein/prebetal-lipoprotein in Swedish middle-aged males and in patients with coronary heart disease.
        Clin. Genet. 1975; 7: 334
        • Nachman R.L.
        • Gavish D.
        • Azrolan N.
        • Clarkson T.B.
        Lipoprotein (a) in diet-induced atherosclerosis in non-human primates.
        Arteriosclerosis. 1991; 11: 32
        • Jurgens G.
        • Ashy A.
        • Esterbauer H.
        Detection of new epitopes formed upon oxidation of low density lipoprotein, lipoprotein (a) and very low density lipoprotein.
        Biochem. J. 1990; 265: 605
        • Dahlen G.H.
        • Guyton J.R.
        • Altar M.D.
        • Farmer J.A.
        • Kautz J.A.
        • Cotto A.M.
        Association of levels of lipoprotein Lp(a), plasma lipids and other lipoproteins with coronary artery disease documented by angiography.
        Circulation. 1986; 74: 758
        • Durrington P.N.
        • Ishola M.
        • Hunt L.
        • Arrol S.
        • Bhatnagar D.
        Apolipoprotein (a), Al and B and parental history in men with early onset ischaemic heart disease.
        Lancet. 1988; : 1070
        • Maeda S.
        • Abe A.
        • Seishima M.
        • Makino A.
        • Noma A.
        • Kawade M.
        Transient changes of serum lipoprotein(a) as an acute phase protein.
        Atherosclerosis. 1989; 78: 146-150
        • Kawade M.
        • Maeda S.
        • Abe A.
        • Yamashiro M.
        Alterations in plasma Lp(a) lipoprotein (Lp(a)) and acute phase proteins after surgical operations.
        Clin. Chem. 1984; 30: 941
        • Durrington P.N.
        • Mackness M.I.
        Lipoprotein separation and analysis for clinical studies.
        in: Converse C. Skinner R. Lipoprotein Analysis: A Practical Approach. Oxford University Press, Oxford1991: 1-42
        • Durrington P.N.
        • Bolton C.H.
        • Hartog M.
        Serum and lipoprotein apolipoprotein B levels in normal subjects and patients with hyperlipoproteinaemia.
        Clin. Chim. Acta. 1978; 82: 151
        • Durrington P.N.
        • Whicher J.T.
        • Warren C.
        • Bolton C.H.
        • Hartog M.
        A comparison of methods for immuno assay of apolipoprotein B in man.
        Clin. Chim. Acta. 1976; 71: 95
        • Haines A.P.
        • Howarth D.
        • North W.R.S.
        • et al.
        Haemostatic variables and the outcome of myocardial infarction.
        Thromb. Haemostasis. 1983; 50: 800
        • Magnani B.
        • Massone P.P.B.
        • Meriggi F.
        • di Jeso F.
        The variation of serum lipoprotein (a) during surgical operations.
        Clin. Chim. Acta. 1992; 212: 149-151
        • Gore J.M.
        • Goldberg R.J.
        • Matsumoto A.
        • Castelli W.P.
        • McNamara P.M.
        • Dalen J.E.
        Validity of serum cholesterol level obtained within 24 hours of acute myocardial infarction.
        Am. J. Cardiol. 1984; 54: 722
        • Ryder R.E.J.
        • Hayes M.
        • Mulligan J.P.
        • et al.
        How soon after myocardial infarction should plasma lipid values be assessed?.
        Br. Med. J. 1984; 289: 722
        • Dodds C.
        • Mills G.L.
        Influence of myocardial infarction on plasma-lipoprotein concentration.
        Lancet. 1959; 11: 1160
        • Miller N.E.
        Effects of adrenoreceptor-blocking drugs on plasma lipoprotein concentrations.
        Am. J. Cardiol. 1987; 60: 17E
        • Armstrong V.W.
        • Neubauer C.
        • Schutz E.
        • Trebbe V.
        Abstract. European Atherosclerosis Society, Bruge, BelgiumMay 1990