Correlation Analysis Of Plasma Lipoprotein A [Lp(a)] Levels With The Occurrence And Severity Of Coronary Heart Disease And Coronary Calcification

Objective Low-density lipoprotein cholesterol(LDL-C)has been well known as a risk factor for coronary artery disease(CAD).However,the role of lipoprotein(a)[Lp(a)]in the development of CAD is of great interest but still controversial.Thus,we aim to explore the effect of Lp(a)on predicting the presence and severity of CAD in Chinese untreated patients,especially in combination with LDL-C.Methods We consecutively recruited 1,980 non-treated patients undergoing coronary angiography,among which 1,162 patients were diagnosed with CAD.Gensini score(GS)was used to assess the severity of CAD.Lp(a)was measured by immunoturbidimetric method.Results Patients with CAD had higher level of LDL-C and Lp(a)compared with non-CAD(P<0.05).Multivariable logistic regression revealed that Lp(a)>205 mg/L(highest tertile)predicted 1.437-fold risk for CAD(95%CI:1.108-1.865,P=0.006)and 1.480-fold risk for high GS(95%CI:1.090-2.009,P=0.012)respectively.Interestingly,concomitant elevated level of Lp(a)and LDL-C conferred the highest risk for both presence[OR=1.845,95%CI:1.339-2.541,P<0.001]and severity[OR=1.736,95%CI:1.188-2.538,P=0.004]of CAD.Conclusion Lipoprotein(a)is a useful marker for predicting the presence and severity of CAD,especially combined with LDL-C.Aim The present study aimed to explore the association between plasma Lp(a)levels and CAC in Chinese patients with angina-like chest pain who underwent cardiac computed tomography(CT)scan.Methods A total of 1085 participants with angina-like chest pain who underwent cardiac computed tomography(CT)scan in Fuwai Hospital were recruited in this study.The CACS was calculated according to the Agatston scoring algorithm.Traditional lipid profiles and Lp(a)were measured for all subjects.Results Patients with CACS>0 had significantly higher plasma Lp(a) concentrations compared with those with CACS=0[23.60(14.73-44.56)mg/dL vs.12.73(5.60-30.11)mg/dL,P<0.001].Multivariable linear regression analysis suggested that the plasma Lp(a)concentration was positively associated with CAC(?=0.543,P<0.001).The area under the curve(AUC)for plasma Lp(a)levels in predicting CAC was 0.71(95%CI 0.68-0.74,P<0.001).Conclusions The plama Lp(a)levels were significantly associated with CAC in Chinese patients with angina-like chest pain who underwent cardiac computed tomography(CT)scan.