Elevated Lp(a) Levels Correlate with Severe and Multiple Coronary Artery Stenotic Lesions

Abstract

Backgrounds and Aims The role of Lipoprotein(a) (Lp(a)) in increasing the risk of cardiovascular diseases is reported in several populations. The aim of this study is to investigate the correlation of high Lp(a) levels with the degree of coronary artery stenosis. Methods Two hundred and sixty-eight patients were enrolled for this study. Patients who underwent coronary artery angiography and who had Lp(a) measurements available were included in this study. Binomial logistic regressions were applied to investigate the association between Lp(a) and stenosis in the four major coronary arteries. The effect of LDL and HDL Cholesterol on modulating the association of Lp(a) with coronary artery disease (CAD) was also evaluated. Multinomial regression analysis was applied to assess the association of Lp(a) with the different degrees of stenosis in the four major coronary arteries. Results Our analyses showed that Lp(a) is a risk factor for CAD and this risk is significantly apparent in patients with HDL-cholesterol ≥35 mg/dL and in non-obese patients. A large proportion of the study patients with elevated Lp(a) levels had CAD even when exhibiting high HDL serum levels. Increased HDL with low Lp(a) serum levels were the least correlated with stenosis. A significantly higher levels of Lp(a) were found in patients with >50% stenosis in at least two major coronary vessels arguing for pronounced and multiple stenotic lesions. Finally, the derived variant (rs1084651) of the LPA gene was significantly associated with CAD. Conclusion Our study highlights the importance of Lp(a) levels as an independent biological marker of severe and multiple coronary artery stenosis.

A potentially underestimated predictor of coronary artery disease risk: The ApoB/ApoA1 ratio

“…High levels of Lp(a) are associated with an increased risk of CAD and atherosclerosis [ 10 ], and Lp(a) and LDL-C share a similar structure, but metabolic regulation appears to be relatively independent and functionally distinct [ 11 ]. Oxidized phospholipid Lp(a) acts as a preferred proinflammatory and proatherogenic lipoprotein carrier [ 12 ].…”

“…Oxidized phospholipid Lp(a) acts as a preferred proinflammatory and proatherogenic lipoprotein carrier [ 12 ]. Studies have shown that Lp(a) as a risk factor for CAD is more pronounced in patients with high-density lipoprotein cholesterol (HDL-C) ≥35 mg/dL and non-obese patients [ 11 ]. Lp(a) and oxidized phospholipids apoB (OxPL-apoB) are associated with multiple coronary artery lesions, and Lp(a), OxPL-apoB, and OxPL-apo(a) are associated with cardiovascular events [ 13 ].…”