The Relationship Between Small And Dense Low Density Lipoprotein Cholesterol And Lpa And Severity Of Coronary Artery Lesion

Objective:To investigate the relationship between small and dense low density lipoprotein cholesterol(sd LDL-C)and lipoprotein a(Lpa)in peripheral blood and severity of coronary artery disease in patients with coronary heart disease.Methods:From August 2018 to February 2019,203 patients with heart disease were selected from the Department of Cardiovascular Medicine,second Clinical Medical College of Shanxi Medical University and underwent coronary angiography due to symptoms of precordial discomfort such as chest hold-up,chest pain and so on.According to the results of angiography and clinical symptoms,they were divided into two groups: coronary disease group(n = 153)and normal coronary group(non-coronary heart disease group,n = 50).According to the clinical diagnostic criteria,the former were divided into stable angina group(SA group,n = 53),unstable angina group(UA group,n = 50)and acute myocardial infarction group(AMI group,n = 50),and according to the results of angiography,the patients were divided into stable angina group(UA group,n = 50)and acute myocardial infarction group(AMI group,n = 50).The former was further divided into three groups: single vessel disease group(n = 57),double vessel disease group(n = 46)and three vessel disease group(n = 50).The clinical indexes and serum levels of sd LDL-C and Lpa were compared among the three groups.The severity of coronary artery lesion was assessed by Gensini score and the number of vessels involved.Results:The clinical indexes and serum sd LDL-C,Lpa levels were compared between CHD group and non-CHD group: age,sex,hypertension,diabetes mellitus,smoking,drinking ratio and TG,UA,D-dimer were compared between the two groups.There was no significant difference(P > 0.05).There was a significant difference in serum sd LDL-C and LPa levels(P < 0 05).The levels of serum sd LDL-C,Lpa in SA group,UA group and AMI group were higher than those in non-CHD group,and the levels of serum sd LDL-C and Lpa were higher in CHD group and non-CHD group than those in non-CHD group.The disease increased gradually in each group(P < 0.05).The level of serum sd LDL-C,Lpa in non-coronary heart disease group was higher than that in non-coronary heart disease group,and the level of serum sd LDL-C,Lpa in two-vessel lesion group was higher than that in non-coronary artery disease group,and the serum sd LDL-C,Lpa level in two-vessel lesion group was higher than that in non-coronary artery disease group.Compared with the two-vessel disease group,the serum levels of sd LDL-C and Lpa were higher than those of the two-vessel disease group,and the serum levels of them increased gradually with the increase of the number of coronary artery lesions(P < 0.05).Integration of Serum sd LDL-C,LPa and Gensini under ROC Curve the differences were 0.761(95%CI:0.683~0.838)and 0.775(95%CI:0.695~0.855),indicating that the levels of serum sd LDL-C and LPa were related to the Gensini score.Further Pearson correlation showed that the serum contents of,sd LDL-C and Lpa were positively correlated with the Gensini score.The correlation coefficients were 0.605 and 0.524,P values were 0.002 and 0.000,respectively.Logistic regression analysis showed that serum sd LDL-C and Lpa were associated with coronary heart disease.The patient level was an independent predictor of coronary heart disease(P < 0.05).Conclusion:The level of sd LDL-C,Lpa increased in patients with coronary heart disease,both of them have important correlation to predict the occurrence and severity of coronary heart disease.