Analysis Of Correlation Between Lipoprotein A Level And Coronary Atherosclerosis Progression

Objective To discuss the correlation between the level of plasma lipoprotein a(Lp(a))and the progression of coronary artery stenosis(indicated by Gensini score)in patients with coronary atherosclerotic heart disease through data collection and statistical analysis.Methods Hospital discharge medical records were retrieved by HIS system of Jiangsu Subei People’s Hospital.Patients who underwent coronary angiography twice in the Department of Cardiovascular medicine between January 2016 and December 2021 with a time interval of 12 to 24 months were screened out.They were 40 to 80 years old,and their medical records were complete.After obtaining relevant medical records,coronary angiography data,and other medical research and laboratory examination data of the population involved,plasma Lp(a)detection was performed by immunoturbidimetry;Gensini score was used to evaluate the severity of coronary artery lesions.According to the difference of two Gensini scores,the two groups were divided into a progressive group(positive difference)and a non-progressive group(negative difference).The levels of general data,Lp(a)and other related biochemical indicators were compared between the two groups.In the advanced group,the pseudo-Gensini score progress was 20 as the boundary,and they were divided into highly advanced group(Gensini score progress >20)and low progression group(Gensini score progress ≤20).The levels of general data,Lp(a)and other lipid indexes were compared between the two groups.Spearman correlation analysis was performed between Lp(a)and other biochemical indicators and the difference of two Gensini scores,and the above data were included in multivariate Logistic regression analysis to analyze the key risk factors leading to the severity and further progression of coronary atherosclerotic disease.The ROC curve evaluated the predictive value of Lp(a)level for coronary artery stenosis.Results 217 cases were included,including the progressive group(n=133 cases)and the improved group(n=84 cases).BMI,proportion of hypertension patients,Lp(a)level and LDL-C level in the progressive group were significantly higher than those in the non-progressive group(P<0.05);They were divided into highly advanced group(n=53)and low-advanced group(n=80).Lp(a)level of highly advanced group was significantly higher than that of low-advanced group(p<0.05).Multivariate Logistic regression analysis showed that high Lp(a)level was an independent risk factor for progression of coronary artery stenosis in patients with coronary heart disease.Spearman correlation analysis showed that LDL-C and Lp(a)were positively correlated with the difference of Gensini scores,that is,the higher the level of LDL-C and Lp(a) was,the higher the Gensini score was.ROC curve was used to evaluate the predictive value of plasma Lp(a)level on the severity of coronary artery stenosis lesions,AUC=0.858,standard error 0.027,95%CI(0.805,0.912),P < 0.001,which was statistically significant.Conclusion(1)The plasma Lp(a)level is positively correlated with the progression of coronary artery stenosis in patients with coronary atherosclerotic heart disease,that is,the higher the Lp(a)level,the more obvious the progression of the disease.(2)In patients with coronary heart disease,the higher the plasma Lp(a)level,the greater the degree of coronary artery stenosis.Lp(a)may be used as a predictor of the risk of recurrence of cardiovascular events in these patients.