Lipoprotein (a) does not influence hyperfibrinolysis in patients with liver cirrhosis

In the attempt of evaluating the relationship between lipoprotein (a) [Lp(a)] and fibrinolytic system, we measured Lp(a) in 49 liver cirrhosis (LC) patients with and without hyperfibrinolysis. Lp(a) values progressively decreased from low to severe liver failure and were significantly correlated with serum albumin (Rho=0.41, p=0.014), prothrombin activity (Rho=0.45, p=0.0021), prekallikrein (Rho=0.48, p=0.0042) and factor VIIa (Rho=0.58, p=0.0004). Twenty-one of LC patients had high values of D-dimer and showed higher tissue-type plasminogen activator (t-PA) and lower tissue-type plasminogen inhibitor (PAI-1) and Lp(a) than patients with normal values of D-dimer. However, no difference of Lp(a) was observed in patients with the same degree of liver failure with and without high values of D-dimer. The relationship between Lp(a) serum levels and D-dimer was also examined by dividing patients with Lp(a) > or <0.27 g/l, which was the median value found in LC population. The two groups showed no different mean values of D-dimer and the same prevalence of patients with high D-dimer. Our study provides in vivo evidence that fibrinolytic system activation is not influenced by Lp(a) serum levels.