Lipoprotein(a) as a Marker for Predicting the Presence and Severity of Coronary Artery Disease in Untreated Chinese Patients Undergoing Coronary Angiography

Objective Low-density lipoprotein cholesterol(LDL-C) has been well known as the risk factor of 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.