The Study Of The Relationship Between Serum Lipoprotein(a) Levels And Atorvastatin In Patients With Cardiac-cerebral Vascular Disease

Objective: To evaluate the characteristics and the clinical predictivevalue of Lipoprotein (a) in patients with cardiac-cerebral vascular disease.To research the significance of different lipid components, such astriglycerides, total cholesterol, high density lipoprotein cholesterol,low-density lipoprotein cholesterol, apolipoprotein A1, apolipoprotein B,in diagnosis of cardiac-cerebral vascular disease, and they associationwith Lipoprotein (a). When removing the multiple factors, we view therelationship between serum Lipoprotein (a) levels and atorvastatin. So aswe can to predict the risk of cardiac-cerebral vascular disease and providea reference for its diagnosis and treatment.Method: Total of344inpatients who had been diagnosedcardiac-cerebral vascular disease, including112cases of angina pectoris,122cases of myocardial infarction,78cases of ischemic stroke and32cases of hemorrhagic stroke, during the period from November2011toOctober2013at China-Japan Friendship Hospital of Jilin University wereenrolled, while collecting300healthy people as control. Detect the serum levels of triglycerides, total cholesterol, high density lipoproteincholesterol, low-density lipoprotein cholesterol, apolipoprotein A1andapolipoprotein B in patients and control groups. Select150patientswhose liver function, kidney function, high density lipoproteincholesterol levels were in the normal reference range, without diabetes,hypertension, family history of cardiac-cerebral vascular disease. Afteratorvastatin treatment, regular follow-up the changes of Lp(a).Result:1. Lipoprotein(a)(mg/dl)(17.5[148.6]vs8.7[27.3], p<0.01), totalcholesterol (mmol/L)(5.69±0.94vs4.96±0.89, p<0.01), low densitylipoprotein cholesterol (mmol/L)(3.12±0.83vs2.17±0.75, p<0.01), totalcholesterol/high density lipoprotein cholesterol ratio(4.65±1.52vs4.01±1.12, P<0.01), low density lipoprotein cholesterol/highdensity lipoprotein cholesterol ratio (2.63±0.90vs2.20±0.80, p<0.01) andapolipoprotein B (g/L)(0.98±0.23vs0.80±0.25, p<0.01) weresignificantly higher in patients than controls. High density lipoproteincholesterol (mmol/L)(1.15±0.26vs1.42±0.30, p<0.01) and apolipoproteinA1(g/L)(1.19±0.42vs1.33±0.45, p<0.01) were significantly lower inpatients than controls. But triglycerides (mmol/L)(1.67±0.95vs1.69±1.40,p-ns) was not statistically different in two groups.2. Patients with high lipoprotein (a) levels (values of more than30mg/dl) had high density lipoprotein cholesterol significantly lower thanrest of the patients group. High density lipoprotein cholesterol (mmol/L) (1.06±0.32vs1.14±0.27, p<0.05). However, triglycerides (mmol/L)(1.68±0.94vs1.66±1.01, p-ns), total cholesterol (mmol/L)(5.67±0.98vs5.70±0.95, p-ns), low density lipoprotein cholesterol(mmol/L)(3.13±0.90vs2.97±0.88, p-ns) were not statistically different intwo groups.3. Patients with Cardiac-cerebral vascular disease allocated toatorvastatin(20mg/day)10weeks and12weeks presented withsignificantly lower Lp(a) levels than baseline Lp(a) levels(9.5[97]mg/dlvs16.5[140]mg/dl [p<0.05] and9[100]mg/dl vs16.5[140]mg/dl [p<0.05],respectively). In contrast, the treatment in the first8weeks, Lp(a) levelsdid not change significantly.4. During the experiment, patients had no allergic reactions, myalgia,myositis, rhabdomyolysis, hepatic injury and other adverse reactions.Conclusion:1. Lipoprotein (a) levels is significantly higher in patientswith cardiac-cerebral vascular disease. It is a risk factor and may beinvolved in the occurrence of cardiac-cerebral vascular disease.2. Total cholesterol, low density lipoprotein cholesterol, totalcholesterol/high density lipoprotein cholesterol ratio, low densitylipoprotein cholesterol/high density lipoprotein cholesterol ratio andapolipoprotein B in patients with cardiac-cerebral vascular disease aresignificantly higher, while high density lipoprotein cholesterol andapolipoprotein A1are significantly lower. That indicate these parameters play an important role in diagnosing cardiac-cerebral vascular disease.3. Patients with very high Lp(a) levels have lower high densitylipoprotein cholesterol levels. If they are used jointly at clinic, it may bemore beneficial for the prediction of cardiac-cerebral vascular disease.4. Atorvastatin can effectively reduce the Lp(a) levels of patientswith cardiac-cerebral vascular disease. Lp(a) may be considered as anindicator of atorvastatin evaluation.