Is lipoprotein(a) regulating prostaglandin I2-synthesis stimulating plasma factor?

INTRODUCTION: Lipoprotein(a) - Lp(a) is accepted as an independent risk factor for the development of atherosclerosis. The mechanism, however, and how it exerts its pathogenetic role is still unclear. More than a decade ago a deficiency of prostacyclin synthesis stimulating plasma factor (PF) was claimed to be associated with an increased Lp(a). OBJECTIVE: The aim of this retrospective analysis was to assess whether elevated Lp(a) is associated with a PF-deficiency and whether certain risk factors may exert influence. METHODS: In a total of 185 patients (131 men and 54 women), aged 30-85 years, suffering from clinically manifested atherosclerosis risk factor profile, lipids, lipoproteins and PF under drug intake were evaluated. RESULTS: Patients with absent PF-activity did not differ concerning age, height, weight, body mass index, waist circumference and different lipid and lipoprotein parameters. Mean Lp(a) in patients with absent PF-activity was 18 vs. 94 mg/dl (p < 0.001). Laboratory parameters such as C-reactive protein, fibrinogen, protein 5, protein C, activated protein C resistance and others were not different. In patients with normal (< 30 mg/dl) Lp(a) only 4 males (3.4%) and 3 females (4.8%) had PF-deficiency, while the Lp(a) cut-off of 30 mg/dl the prevalence was 61.1% males and 64.4.% females. CONCLUSION: These findings indicate that the association of PF-deficiency with increased Lp(a), at least in part, could contribute to the pathogenesis of atherosclerosis in these patients.