Serum Lipoprotein (a) Levels in Patients with First Unprovoked Venous Thromboembolism is not Associated with Subsequent Risk of Recurrent VTE

• Published in: Thrombosis research Vol. 126; no. 3; pp. 222 - 226
• Main Authors: Rodger, M.A, Le Gal, G, Carrier, Marc, Betancourt, M.T, Kahn, S.R, Wells, P.S, Anderson, D.A, Lacut, K, Chagnon, I, Solymoss, S, Crowther, M, Perrier, A, White, R, Vickars, L, Ramsay, T, Kovacs, M.J
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.09.2010; Elsevier
• Subjects: Adult; Aged; Anticoagulants; Anticoagulants - administration & dosage; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Biological Markers; Biomarkers - blood; Blood and lymphatic vessels; Canada; Cardiology. Vascular system; Chi-Square Distribution; Cohort; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Drug Administration Schedule; Europe; Female; Hematology, Oncology and Palliative Medicine; Human health and pathology; Humans; Kaplan-Meier Estimate; Life Sciences; Lipoprotein a; Lipoprotein(a) - blood; Logistic Models; Male; Medical sciences; Middle Aged; Odds Ratio; Prospective Studies; Recurrence; Risk Assessment; Risk factor; Risk Factors; Time Factors; Treatment Outcome; Up-Regulation; Venous Thromboembolism; Venous Thromboembolism - blood; Venous Thromboembolism - drug therapy; Venous Thromboembolism - mortality; Venous thrombosis; Canada; Europe; Anticoagulants; Venous thrombosis; Cohort; Lipoprotein a; Risk factor; Vascular disease; Human; Deep vein thrombosis; Cardiovascular disease; Anticoagulant; Thromboembolism; Venous disease
• ISSN: 0049-3848; 1879-2472
• DOI: 10.1016/j.thromres.2010.06.007

Abstract Introduction Case-control studies suggest that elevated lipoprotein (a) (Lp(a)) is a risk factor for first venous thromboembolism (VTE). Lp(a) has not been prospectively investigated as a possible risk factor for recurrent VTE in first unprovoked VTE patients. We sought to determine if serum Lp(a) levels in patients with unprovoked VTE who discontinue anticoagulants after 5 to 7 months of therapy predict VTE recurrence in a prospective cohort study. Materials and Methods Serum Lp(a) measurements were obtained from 510 first unprovoked VTE patients treated for 5 -7 months with anticoagulants in a 12 center study. Patients were subsequently followed for a mean of 16.9 months (SD ± 11.2) for symptomatic VTE recurrence which was independently adjudicated with reference to baseline imaging. Results There was no significant association between Lp(a) as a continuous variable and recurrent VTE nor in gender stratified subgroups. No statistically significant differences were observed in the median Lp(a) concentrations between patients who recurred and those who did not recur (median (interquartile range): 0.09 g/L (0.17) versus 0.06 g/L (0.11) respectively; p = 0.15). The Lp(a) cut-off point of 0.3 g/L was not significantly associated with recurrent VTE for the overall population nor in gender stratified subgroups. Conclusions Elevated serum Lp(a) does not appear to be associated with recurrent VTE in patients with history of first unprovoked VTE and may not play a role in identifying patients with unprovoked VTE at high risk of recurrence. There was no optimal predictive threshold for the overall population or for sex sub-groups and Lp(a) ≥ 0.3 g/L was not a significant predictor of recurrent VTE.