Exploring The Relationship Between Plasma Lipoprotein(a) And The Severity Of Coronary Artery Lesions

Background:Coronary heart disease(CHD)is a clinically common form of chronic cardiovascular disease(CVD)and is one of the major cause of serious human health problems now.Studies have shown that plasma lipoprotein(a)[Lp(a)] is an inherited risk factor for CVD,and that Lp(a)is involved in the development and progression of CVD,mainly by promoting atherosclerosis(AS),promoting inflammatory responses and promoting thrombosis.However,some studies have suggested that the level of plasma low density lipoprotein cholesterol(LDL-C)concentrations may affect the ability of Lp(a)to predict increased CVD risk.There is no conclusive evidence as to whether Lp(a)correlates with the severity of coronary artery lesions,and few studies have been conducted to determine whether Lp(a)levels correlate with the severity of coronary artery lesions in the context of different levels of LDL-C.The aim of this paper is to investigate the relationship between Lp(a)levels and the severity of coronary artery lesions,and to investigate the correlation between Lp(a)levels and the degree of coronary stenosis in the context of different plasma concentrations of LDL-C,in order to provide a theoretical basis for the clinical management of CHD.Methods:This paper used a retrospective analysis to include 164 patients who underwent first-time percutaneous coronary angiography(CAG)at the Department of Cardiovascular Medicine,Sino-Japanese Friendship Hospital of Jilin University between January 2021 and December 2021 and were diagnosed with CHD.Patients who met the inclusion and exclusion criteria had routine lipid and Lp(a)tests performed on an empty stomach on the following day.Baseline clinical data,lipid profile and CAG results were collected and collated from all patients enrolled.The severity of coronary lesions(degree of stenosis)was assessed using the Gensini(GS)score,and the GS scores were divided into four groups according to quartiles,and the trends of the clinical baseline data and blood lipid profile were compared between different subgroups;spearman correlation analysis was used to explore the correlation between Lp(a)levels and GS scores,and to investigate the relationship between Lp(a)and the severity of coronary lesions in the context of different levels of LDL-C and in different gender and age subgroups;multiple linear regression was used to analyse the value of Lp(a)in predicting the severity of coronary lesions.Results:(1)Analysis of the clinical data of patients in the subgroup with different GS scores revealed differences in type of CHD,diabetes,drinking history,number of lesions,aspartate aminotransferase(AST),Lp(a)and LDL-C were statistically significant(P < 0.05).The higher the Lp(a)level and the higher the GS score compared to the four groups,suggesting the more severe the coronary artery lesion was,and the difference was statistically significant(P <0.001).(2)Spearman correlation analysis showed positive correlation between Lp(a)levels and the severity of coronary lesions in CHD patients(r=0.54,P<0.001);in the LDL-C subgroup,Lp(a)levels were positively correlated with the severity of coronary lesions regardless of LDL-C concentration(P<0.001);In the gender subgroup,the correlation between Lp(a)level and the severity of coronary lesions was stronger in men(r=0.72,P<0.001);in the age subgroup,the correlation between Lp(a)level and the severity of coronary lesions was stronger in patients with earlyonset CHD than in patients with late-onset CHD(r=0.75 vs 0.66,P<0.001).After adjusting for confounders in the above subgroups,Lp(a)levels remained positively correlated with the severity of coronary lesions(P <0.05).(3)Multiple linear regression analysis showed that Lp(a)was an independent risk factor for the severity of coronary lesions(β=0.65,P<0.001,95%CI=0.46-0.84).Conclusion:(1)Lp(a)levels were positively correlated with the severity of coronary lesions,the higher the Lp(a)level,the more severe the coronary artery lesions.And the correlation was stronger in patients with the male CHD and early-onset CHD.(2)Lp(a)levels are positively correlated with the severity of coronary lesions,regardless of LDL-C levels.(3)Lp(a)is an independent risk factor for the severity of coronary artery lesions.