Study On The Correlation Between Lipoprotein(a) And SYNTAX Score In Patients With Premature Coronary Heart Disease

Background:Lipoprotein(a)[Lp(a)] is a plasma lipoprotein,which is mainly influenced by genetic factors.Studies have shown that elevated Lp(a)levels may be an independent risk factor for cardiovascular disease.SYNTAX score is a tool for evaluating the severity of coronary artery lesions,and it mainly bases on lesion site,degree of stenosis and lesion characteristics for quantitative evaluation,and is widely used in clinical diagnoses and treatment.Previous some studies have shown that the higher Lp(a)levels were independently associated with increased CHD risk,but the relationship between Lp(a)and SYNTAX score is unclear.This study aims to explore the correlation between lipoprotein(a)and SYNTAX score in patients with premature coronary heart disease.Methods:1.From January 1,2019 to December 31,2019,patients were suspected coronary atherosclerotic heart disease and underwent coronary angiography in the Second Affiliated Hospital of Nanchang Universityl were selected in our study.The men were younger than 55 and the women were younger than 65.2.Baseline information of patients included in this study was collected,including gender,age,height,weight,body mass index(BMI),smoking status,history of hypertension and medication history,history of diabetes and medication history,and statins use.Laboratory data included hemoglobin(Hb),platelet count(PLT),glycosylated hemoglobin(Hb A1c),uric acid(UA),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),lipoprotein(a)[Lp(a)] and other biochemical indicators.According to the results of coronary angiography,the SYNTAX score was calculated for all the patients with premature coronary artery disease,and the patients were divided into three groups according to the score of SYNTAX score: low-risk SYNTAX group(SYNTAX score ≤22 points),medium-risk SYNTAX group(SYNTAX score 23-32 points),and high-risk SYNTAX group(SYNTAX score ≥33points).Multiple regression analysis was conducted between Lp(a)level and SYNTAX score in patients with premature coronary heart disease.Results:A total of 1459 patients were enrolled in this study,including 477 patients with premature coronary heart disease diagnosed by coronary angiography and 982 patients without coronary artery disease.According to the SYNTAX score,477 patients with premature coronary heart disease were divided into three groups: 363 cases in the low-risk SYNTAX group,71 cases in the medium-risk SYNTAX group,and 43 cases in the high-risk SYNTAX group.Lp(a)level was significantly higher in premature coronary artery disease patients than in non-CHD patients [18.38(10.14-38.73)VS.14.98(7.55-33.03),P < 0.001].In multivariate Logistic regression analysis,after adjusting for gender,BMI,history of diabetes mellitus,history of hypertension,smoking history,basic statin use,Hb A1 c,TC,TG,LDL-C,and HDL-C,Lp(a)was positively associated with premature coronary artery disease(OR=1.51,95%CI:1.15-1.97,P=0.003).Lp(a)level was the highest in Syntax high-risk group[23.65(17.39-60.32)VS.21.33(13.41-50.23)VS.17.00(8.63-35.38),P<0.001].Spearman correlation analysis was performed between each lipoprotein and SYNTAX score,and Lp(a)(r=0.235,P<0.001)was positively correlated with SYNTAX score.Multiple linear regression analysis showed that Lp(a)was positively correlated with SYNTAX score(B=5.407,95%CI:3.387-7.427,P < 0.001),after adjusting for gender,age,TG,TC,HDL-C,and LDL-C.Conclusion:In this study,the results shown that Lp(a)level was not only significantly correlated with premature coronary heart disease,but also positively correlated with SYNTAX score for premature coronary heart disease.The findings suggested Lp(a)had a good predictive value for the severity of coronary artery disease.