Lipoprotein(a) as predictor of coronary artery disease and myocardial infarction in a multi-ethnic Asian population.

Abstract

BACKGROUND AND AIMS:

The role of Lp(a) in multi-ethnic Asian populations with coronary artery disease (CAD) has not been well established. The aims of this study were (i) to investigate whether Lp(a) is a predictor of CAD, and (ii) amongst patients with CAD, to ascertain whether Lp(a) is a predictor of acute myocardial infarction (AMI) and severity of CAD.

METHODS:

We compared three cardiovascular phenotypes from patients recruited at coronary angiography. CAD was defined as ≥50% coronary artery stenosis and subdivided into a group with AMI history (CAD+AMI+) and a group without (CAD+AMI-). Minimal CAD group (CAD-) was defined as normal or <30% coronary artery stenosis and no AMI. The severity of CAD was defined using the modified Gensini score.

RESULTS:

We studied 2025 patients comprising 94.5% men and 61.4% of Chinese ethnicity. The median Lp(a) level was highest in CAD+AMI+, followed by CAD+AMI- and CAD- (26.2, 20.1, and 15.8 nmol/L respectively). Similarly, the frequency of patients with Lp(a) ≥120 nmol/L were in the same order (11.8%, 9.1% and 2.4%). Lp(a) levels were highest among Asian Indians, followed by Malays and Chinese patients (p < 0.001). Lp(a) levels and Lp(a) ≥120 nmol/L were significant predictors of CAD (Odds ratio (OR) = 1.12 per 10 nmol/L increment, p < 0.001, and OR = 5.41 p = 0.004 respectively). Among patients with CAD, higher Lp(a) levels were associated with increased AMI risk (OR = 1.02 per 10 nmol/L increment, p = 0.024). Lp(a) ≥120 nmol/L was positively associated with CAD severity (p = 0.020).

CONCLUSIONS:

Plasma Lp(a) concentration is a positive predictor of CAD and AMI in a mostly male South East Asian population.

• Authors: Wann Jia Loh, Xuling Chang, Tar Choon Aw, Soon Kieng Phua, Adrian F Low, Mark Yan-Yee Chan, Gerald F Watts, Chew-Kiat Heng
• Journal: Atherosclerosis (Atherosclerosis) Vol. 349 Pg. 160-165 (05 2022) ISSN: 1879-1484 [Electronic] Ireland
• PMID: 34887076 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 Elsevier B.V. All rights reserved.

Chemical References

• Lipoprotein(a)

Topics

• Coronary Angiography
• Coronary Artery Disease (diagnostic imaging, epidemiology)
• Coronary Stenosis (diagnostic imaging, epidemiology)
• Ethnicity
• Female
• Humans
• Lipoprotein(a)
• Male
• Myocardial Infarction (diagnosis, epidemiology)
• Risk Factors
• Severity of Illness Index