Plasma Lipoprotein(a) Levels Are Associated With The Severity Of Coronary Heart Disease In Chinese Han People

Objective:To investigate the relationship between lipoprotein(a) [Lp(a)] and the severity of coronary heart disease(CHD).Methods: This cross-sectional study was carried out in 2011-2014 at the Affiliated Hospital of North Sichuan Medical College, Nanchong city, Sichuan province, China. Six hundred and seventy-nine patients with angiographically defined CHD were respectively divided into three groups according to Gensini score or the number of stenotic vessels. Demographic characteristics were collected and plasma lipoproteins were analyzed. Univariate and multivariate ordinal logistic regression analyses were carried out to examine the relationship between Lp(a) and other lipid parameters and the severity of CHD.Results: Correlation between physiological and biochemical factors and severity of coronary artery disease:(1)Gensini score subgroup analysis results:there was no significant difference between the second group and the first group(P>0.05).The third group had higher age(P=0.003),the percentages of males(P=0.011),smoking patients(P=0.022),diabetic patients(P=0.003) and Lp(a) levels(P=0.001) than the first group, and had lower levels of high-density lipoprotein cholesterol(HDL-C)(P=0.014)and apolipoprotein(apo) AI(P=0.002) than the first group,the difference was statistically significant.The third group had higher percentages of males(P=0.035), diabetic patients(P=0.018) and Lp(a) levels(P=0.031) than the second group, and lower levels of high-density lipoprotein cholesterol(HDL-C)(P=0.001) and apolipoprotein(apo) AI(P=0.001) than the second group,the difference was statistically significant.Results showed that the third group had higher the percentages of males,diabetic patients and Lp(a) levels than the first and the second groups,and lower levels of high-density lipoprotein cholesterol(HDL-C)and apolipoprotein(apo) AI than the first and the second groups.(2)The numbers of stenotic vessel subgroup analysis results: Double-branch stenosis group had higher percentages of males(P=0.002),total cholesterol(P=0.001), low-density lipoprotein cholesterol(P=0.004), very low-density lipoprotein cholesterol(P=0.004)and apo B100(P=0.006) than the single-branch stenosis group,the difference was statistically significant. Multi-branch stenosis group had higher age(P=0.000),the percentages of males(P=0.001),diabetic patients(P=0.000), Lp(a) levels(P=0.000),total cholesterol(P=0.001), low-density lipoprotein cholesterol(P=0.004) and apoB100(P=0.014) than single-branch stenosis group,and lower high-density lipoprotein cholesterol(HDL-C)(P=0.004) and apolipoprotein(apo) AI(P=0.013) than single-branch stenosis group,the difference was statistically significant. Multi-branch stenosis group had higher age(P=0.013), hypertensive patients(P=0.017) and Lp(a) levels(P=0.037) than double-branch stenosis group,and lower levels of high-density lipoprotein cholesterol(HDL-C)(P=0.026) and apolipoprotein(apo) AI(P=0.014) than the double-branch stenosis group,the difference was statistically significant. Results showed the Multi-branch stenosis group had significantly higher age and Lp(a) levels than single-branch stenosis and double-branch stenosis group,and lower levels of high-density lipoprotein cholesterol(HDL-C)and apolipoprotein(apo) AI than the single-branch stenosis and double-branch stenosis group.(3)Using Gensini score as dependent variable, the univariate and multivariate logistic regression analyses showed that age, diabetes and Lp(a) were independently associated with the severity of CHD.(4)Using the number of stenotic vessel as dependent variable, the univariate and multivariate logistic regression analyses showed that age, gender, diabetes, HDL-C and Lp(a) were independently associated with the severity of CHD.Conclusion: Our data indicate that plasma Lp(a) levels are consistently associated with the severity of CHD either by Gensini scores or numbers of stenotic vessel.