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Lipoprotein (a) is not part of the acute phase response

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Lipoprotein (a) is not involved in the acute phase response after intense exercise, and therefore not implicated in increasing the risk of a heart attack, concludes a study of army volunteers. The finding contradicts previous research, but this might have been because it was undertaken after the acute phase response in older people who had other underlying disease, suggest the authors.

Two hundred fit and healthy British army recruits were reviewed at the start and finish of a 10 week programme of basic training. The programme concluded with military exercises lasting for 48 hours, designed to push the recruits to the limits of their physical performance. Lipoprotein (a), C reactive protein, fibrinogen, albumin and total creatine kinase values were measured from 12 hours to five days after the final exercise.

There was a clear acute phase response after the final rigorous exercise, defined by significantly increased circulating fibrinogen, reduced albumin, and raised C reactive protein and creatine kinase values. There was no evidence that lipoprotein (a) was an early marker for the acute phase response, although the possibility that there is a delayed response to intense physical effort warrants further attention.

The authors conclude that the acute risks of a heart attack after major physical effort in healthy people or those with heart disease are unlikely to be enhanced by any process involving lipoprotein (a) beyond that associated with baseline values. And they add that these can be measured even after intense physical exercise without fear of compromising the results.