Lipoprotein a (LPa), Fibrinogen and Homocysteine in Patients with Coronary Artery Disease and without Major Risk Factors

Background- Coronary artery disease (CAD) is the major cause of death in the world today.1 Many factors are responsible for causing CAD, but some patients have none of the known major risk factors, i.e. hypertension, diabetes, smoking, hyperlipidemia and family history of CAD.2 Recent studies suggest other factors such as lipoprotein a (LPa), fibrinogen and homocysteine as risk factors for CAD.1 The present study tries to establish the relationship between these three factors with CAD in patients with no other major known risk factor(s). Methods- Sixty-four patients without any known major risk factors whose angiographies showed significant disease in their coronary arteries were selected. Their blood samples were obtained, and their serum homocysteine, fibrinogen and LPa levels were determined. Results- 9.4% of the cases investigated had elevated fibrinogen levels above normal. This was also true for 42.2% and 87.5% of the cases in terms of homocysteine and LPa, respectively. Therefore, of these three factors, LPa seems to have the strongest and fibrinogen the weakest relation with CAD. Conclusion- The results of this study and similar studies indicate that these three factors, particularly homocysteine and LPa, could be considered as independent risk factors for CAD and that controlling them would be a significant step toward preventing cardiovascular diseases (Iranian Heart Journal 2006; 7 (1): 37-39).