Relationship between lipoprotein (a) and coronary artery disease in patients with very high ldl level

Abstract

Background and Aims : Adults who have low density lipoprotein (LDL) cholesterol levels of more than 190 mg/dl are classified in very high-risk group for major cardiovascular events. The data about the impact of Lp(a) on coronary artery disease (CAD) in patients with very high LDL levels is insufficient. We aimed to investigate the relationship of Lp(a) level with CAD in patients with very high LDL levels. Methods: We retrospectively analyzed the data of 247 patients whose LDL levels were equal to or higher than 190mg/dl and who had Lp(a) measurements. Lipid profile, co-morbidities, cardiovascular diseases, blood pressure, body mass index, eGFR and smoking status were assessed. The relationship between Lp(a) levels and CAD was analyzed. Results: A total of 247 patients whose 50.4% were female, 22.6% diabetic and 36.7% hypertensive, 19% had coronary artery disease were included in the analysis. Patients with CAD had higher levels of Lp (a) (median 16 mg/dl vs 23 mg/dl p= 0.024). Age [odds ratio (OR), 1.060; 95% confidence interval (CI): 1.020-1.101; p = 0.003], sex (OR, 6.29; 95% CI:2.604-15.198; p = 0.000) and Lp(a) level (OR, 1.011; 95% CI: 1.001-1.021; p = 0.035) were independently related with CAD. ROC curve analyses demonstrated that Lp(a) level of 19.5mg/dl was the cut-off value for CAD in patients with very high LDL level (AUC:0.6, p=0.023). Conclusions: In our study, we found increased Lp(a) level as a risk factor for CAD in patients with very high LDL levels. Furthermore, our results demonstrate that Lp(a) is the independent predictor of CAD in this patient group.