Study Of The Clinical Importance And Variations In Lipoprotein(a) Levels Between Patients With Acute Myocardial Infarction And Chronic Coronary Syndrome

Aim : Coronary atherosclerotic heart disease(CHD),which has a growing prevalence and a younger population each year,is currently one of the primary diseases that pose a threat to human health.Recent research has demonstrated that CHD and lipoprotein a [Lp(a)] are tightly related.Little research has been done on the severity of Lp(a)and coronary artery lesions(including the location and number of coronary lesions and the degree of stenosis),as well as the variations in Lp(a)levels between patients with various clinical presentations of CHD.Consequently,this study examines the variations in Lp(a)levels between patients with various clinical forms of CHD as well as the relationship between Lp(a)and both the quantity and severity of coronary lesions.Methods:A total of 141 individuals with acute myocardial infarction(AMI)and217 patients with chronic coronary syndrome(CCS)were included.We gathered data on the study participants’ gender,age,marital status,Lp(a),and coronary angiographic results.In order to identify any variations between the baseline data of the two groups,the correlation between Lp(a)level and coronary lesion number,position,and degree of stenosis was examined.The risk variables for coronary artery obstruction(coronary artery stenosis 50%)were clarified using logistic regression analysis,and the utility of Lp(a)in diagnosing the severity of coronary artery stenosis was investigated by producing ROC curves.Results:Gender,age,hypertension,diabetes,history of smoking and drinking,triglycerides,total cholesterol,left ventricular diameter(LVD),and left atrial anteroposterior diameter(LAD)were the only variables that did not significantly differ between the two groups(P > 0.05).The AMI group considerably outperformed the CCS group in terms of Lp(a),coronary lesions,and degree of stenosis(P 0.001).Lp(a)was found to be positively connected with the degree of coronary stenosis in CCS patients(r=0.81,P0.001)but not substantially correlated with AMI patients(r=0.03,P=0.729)according to the Spearman correlation analysis.Only the CCS group showed differences in Lp(a)levels between sites(P=0.01).Binary logistic regression analysis showed that Lp(a),creatine kinase isoenzyme(CKMB)and history of diabetes mellitus were independent risk factors for coronary artery obstruction.The ROC curve was constructed,and it was discovered that Lp(a)172.0mg/L and CKMB 16.5 U/L was the ideal cut-off value for diagnosing coronary blockage,with a sensitivity of 81.9% and specificity of 94.2%,and an area under the curve(AUC)of 0.95,P<0.001.Conclusion:Lp(a)levels were positively linked with the number of coronary artery lesions and the degree of stenosis in AMI patients and were significantly greater in CCS patients.When Lp(a)≥ 172.0 mg/L and CKMB ≥ 16.5 U/L,the degree of coronary artery stenosis can be predicted to be 50% or greater,which also serves as a guide for the diagnosis and treatment of CHD patients.