Rapid Angiographic Progression of Coronary Artery Disease in Patients With Elevated Lipoprotein(a)

Background The mechanisms underlying rapid angiographic progression of coronary artery disease are still unknown. Intravascular thrombosis with or without plaque rupture may be involved. Methods and Results In a prospective study in 79 patients with coronary artery disease and at least one coronary diameter stenosis ≥50%, possible risk factors for rapid progression were investigated. Quantitative coronary angiography was performed twice at a mean time interval of 66±25 days. Rapid progression of coronary disease defined as (1) an increase >10% in stenosis severity in at least one stenosis ≥50%, (2) occurrence of a new stenosis ≥50%, or (3) occlusion of a formerly patent vessel was found in 21 patients (27%). Between patients with rapid progression and those without, there were no significant differences in sex distribution, age, smoking history, frequency of hypertension or diabetes mellitus, and serum LDL cholesterol, HDL cholesterol, and apolipoprotein B concentrations. In contrast, serum lipoprotein(a)...