Prevalence and role of elevated serum lipoprotein(a) in patients with myocardial infarction according to the Russian register of acute myocardial infarction REGION-MI

Objective. Serum lipoprotein(a) (Lp(a))>50 mg/dl is associated with higher risk of cardiovascular diseases and complications. The aim of this study was to assess the prevalence of elevated Lp(a) in patients with acute myocardial infarction (MI) in various regions of the Russian Federation (RF), as well as the prevalence of target level of low-density lipoprotein cholesterol (LDL cholesterol) in these patients. Material and methods. The REGION–IM (Russian Registry of Acute Myocardial Infarction) is a multiple-center prospective observational study. The follow-up included 3 stages: hospital-stay, 6 and 12 months after inclusion in the register. Demographic and anamnestic data, as well as information about MI were entered into the registration card. Lp(a) was analyzed in 1.623 (22%) patients from 40 regions of the Russian Federation. There were 1.173 (72%) men and 450 (28%) women aged 60 years (range 30—94). Results. Mean serum Lp(a) was 12.4 mg/dl (range 2 — 722.2). This value was significantly higher in women (15.5 mg/dl versus 10.8 mg/dl, p<0.05) and STEMI patients (12.9 mg/dl versus 10.8 mg/dl, p<0.05). Serum Lp(a) >50 mg/dl was recorded in 414 (26%) patients, 50—100 mg/dl — 12.9%, 101—180 mg/dl — 2.9%, > 180 mg/dl — 10.3% of patients. Conclusion. Serum Lp(a) > 50 mg/dl was recorded in every fourth patient while extreme elevation (>180 mg/dl) — in every tenth patient of this register. Screening of serum Lp(a) at least once in lifetime will allow determining the category of patients with extremely high risk of cardiovascular complications including those with target level of LDL-C.