Lipoprotein(a) as a predictor for the presence and severity of premature coronary artery disease: a cross-sectional analysis of 2433 patients

Lipoprotein(a) [Lp(a)] has been emerged as a risk factor for coronary artery disease (CAD), but there is currently insufficient data on the relationship between Lp(a) and premature CAD (PCAD). Thus, this study aimed to examine the association between Lp(a) and PCAD in a Chinese cohort.Data on 2433 individuals (male <55 years old and female <65 years old) who underwent coronary angiography from March 2016 to February 2019 were included in this study and were divided into the PCAD group (n = 1751) and non-CAD group (n = 682) according to the angiography results. Their clinical and laboratory parameters were collected, and plasma Lp(a) level was measured by immunoturbidimetry. The severity of CAD was evaluated using Gensini score (GS) and divided into three subgroups. The relationship between plasma Lp(a) levels and the presence and severity of PCAD was analyzed.The level of plasma Lp(a) in the PCAD group was significantly higher than that in the non-CAD group (P < 0.001). The plasma Lp(a) concentration in the highest GS group was significantly higher than that in the lowest GS group (P < 0.001). Multivariate linear regression analysis showed that elevated plasma Lp(a) levels were correlated with higher GS (b = 0.41, P < 0.001). Multivariate logistic regression showed that elevated plasma Lp(a) levels were independently associated with PCAD (odds ratio = 2.91, P < 0.001). Moreover, elevated plasma Lp(a) levels correlated with higher GS (b = 0.41, P < 0.001).In this study, Lp(a) concentration was associated with the presence and severity of PCAD, suggesting that Lp(a) may be a marker or target for patients with PCAD.