ISSN: 0974-276X
Daniel Stalder, Trinh Cung, Steffen Gloekler, Pascal Meier, Evelyn Schlappritzi, André Haeberli, Santica Marcovina, Christian Seiler and Manfred Heller
We discovered and validated medium sized apolipoprotein (a) as a marker for good myocardial collaterization. A total of 80 subjects were investigated in two serial studies: a discovery study (n=14) applying a pooling strategy to a gel and label free proteomics platform followed by a validation study (n=80) measuring apolipoprotein(a) isoforms and concentration in individual subjects. Degree of myocardial collaterization as well as apolipoprotein(a) concentration and isoform determination were performed by state-of-the-art methodologies. As apolipoprotein(a) concentration negatively correlates with isoform size (variable number of Kringle-IV type 2 repeats in human population), subjects were grouped into patients with small, medium and large apolipoprotein(a) isoforms for the statistical analysis. Among the 70 subjects with medium and large apolipoprotein(a) isoforms (>17 Kringle-IV type 2 repeats), subjects with insufficient collaterization (n=57) had a median apolipoprotein(a) concentration of 11.9 nmol/L, while patients with sufficient collaterization (n=13) had a median concentration of 31.3 nmol/L (p=0.033, Mann-Whitney U-test). Among the 52 subjects with medium sized apolipoprotein(a) isoforms (30< Kringle IV type 2 repeats >17) the difference in concentration was even more significant (13.4 vs 33.5 nmol/L, p=0.008).