Analysis Of Correlation Between Lipoprotein(a) And Severity Of Early Coronary Artery Disease

Objective: to investigate the relationship between lipoprotein(a),[Lp(a)] and the severity of coronary artery disease(CAD)in patients with premature coronary artery disease(PCAD),whether high concentration of Lp(a)can be used as a clinical index to evaluate the severity of coronary artery disease in premature coronary heart disease is discussed.Methods: A total of 1,851 hospitalized patients(male < 55 years old,female <65 years old)with early-onset coronary heart disease were selected from the first affiliated hospital of Xinjiang Medical University who underwent coronary 2021 between January2015 and December 2015.They were divided into high-Lp(a)group(N = 721)and low-Lp(a)group(N = 1130)according to whether the lipoprotein(a)concentration was greater than 300 mg/L.Patients with premature coronary artery disease were grouped according to the three-digit number of Gensini scores: 0-20 for mild lesions(low Gensini score group N = 581)and 20-60 for moderate lesions(Middle Gensini score group N =732),> 60 was classified as severe lesion(High Gensini score group,> 60).All patients were collected for their medical history,clinical data and relevant laboratory indexes:creatinine(Cer),fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),Low-density lipoprotein(LDL-C),high-density lipoprotein cholesterol(HDL-C),apolipoprotein a(APOA),apolipoprotein B(APOB)and Lp(a),as well as smoking history,hypertension and diabetes history,the value of Lp(a)in predicting the severity of coronary artery disease in patients with premature coronary heart disease was analyzed by univariate and multivariate Logistic regression,spearman analysis showed the correlation between serum Lp(a)concentration and the severity of premature coronary artery disease.Results: There were significant differences in age,diabetes history,smoking history,total cholesterol,triglyceride,Low-density lipoprotein,Lp(a),apolipoprotein B,fasting blood glucose and Gensini score between high Lp(a)group and low Lp(a)group in patients with premature coronary heart disease(CHD)(p < 0.05).The Gensini score in high Lp(a)group was significantly higher than that in low Lp(a)group(p < 0.01).Compared to the Low Gensini score group,there were significant differences in age,male,history of diabetes,smoking,creatinine,triglyceride,Lp(a),apolipoprotein B and fasting blood glucose between the two groups(p < 0.05),the difference of serum Lp(a)level was more obvious.The serum Lp(a)concentration of middle and High Gensini score group was higher than that of low GENSINI score group.Univariate Logistic regression analysis showed that male,fasting plasma glucose and Lp(a)were significantly correlated with the severity of coronary artery stenosis in patients with premature coronary heart disease.In addition,multivariate Logistic regression analysis showed that male sex,fasting plasma glucose and Lp(a)were predictive factors for the severity of moderate to severe coronary stenosis in patients with premature coronary heart disease,OR = 1.008(CI = 1.006-1.010,p < 0.01)for Lp(a)versus degree of moderate-to-severe coronary stenosis.The ROC curve showed that the area under the curve(AUC)was 0.859(95% CI = 0.841-0.876,p <0.001)The optimal cut-off value of Lp(a)for predicting the presence of moderate-to-severe coronary stenosis was 230.60 mg/L,with a sensitivity of 68.6% and a specificity of 90.2%.Spearman analysis showed that Lp(a)levels were found to be positively correlated with Gensini scores in different subgroups(rs > 0.50,p < 0.01).Conclusions: High Lp(a)level is an independent predictor of moderate to severe coronary artery disease in patients with premature coronary heart disease,and Lp(a)level is positively correlated with the severity of coronary artery stenosis in patients with premature coronary heart disease,the results need to be confirmed by a larger sample of prospective studies.