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Thromb Haemost 1999; 81(01): 104-110
DOI: 10.1055/s-0037-1614426
Review Article
Schattauer GmbH

Lipoprotein(a) Levels and Isoforms and Fibrinolytic Activity in Postmenopause – Influence of Hormone Replacement Therapy

Amparo Estellés
1   From the Research Center, School of Medicine, University of Valencia, Valencia, Spain
,
Antonio Cano
2   From the Department of Obstetrics and Gynecology, School of Medicine, University of Valencia, Valencia, Spain
,
Cristina Falcó
1   From the Research Center, School of Medicine, University of Valencia, Valencia, Spain
,
Francisco España
1   From the Research Center, School of Medicine, University of Valencia, Valencia, Spain
,
Juan Gilabert
3   From the Department of Obstetrics and Gynecology and, School of Medicine, University of Valencia, Valencia, Spain
,
Salvador Grancha
1   From the Research Center, School of Medicine, University of Valencia, Valencia, Spain
,
Justo Aznar
4   From the Department of Clinical Pathology, La Fe University Hospital, and , School of Medicine, University of Valencia, Valencia, Spain
› Author Affiliations
Further Information

Publication History

Received09 February 1998

Accepted after resubmission01 September 1998

Publication Date:
08 December 2017 (online)

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Summary

Epidemiological studies suggest that hormone replacement therapy (HRT) decreases the risk of cardiovascular disease in postmenopausal women via several mechanisms, including modifications in the fibrinolytic system and lipoprotein(a) [Lp(a)] levels. The aim of this study was to examine the influence of the levels and isoforms of Lp(a) on fibrinolytic activity in 91 postmenopausal women in comparison with premenopause and analyze the effect of HRT on those parameters. In postmenopause, an increase in plasma Lp(a) and plasminogen activator inhibitor-1 (PAI-1) levels was found. A significant inverse correlation was observed between Lp(a) or PAI-1 levels and plasmin generation. Plasma samples with low molecular weight (MW) apo(a) isoforms showed higher plasmin inhibition than plasmas with high MW apo(a) isoforms and similar levels of total Lp(a) and PAI-1. HRT induced a significant decrease in Lp(a) and PAI-1 levels and an increase in estradiol levels, as well as an increase in fibrinolytic activity. A significant correlation was found between the percentages of variation in Lp(a) levels and in plasmin generation and between the percentages of variation in PAI-1 levels and in the euglobulin lysis time under HRT. In conclusion, the increase in fibrinolytic activity observed in women under HRT could be explained by two independent mechanisms: (a) the decrease in PAI-1 and (b) the decrease in the inhibition of plasmin generation due to the decrease in Lp(a) levels.

 

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