Lipoprotein(a) as a predictor of chronic coronary syndrome and low-density lipoprotein cholesterol as a predictor of acute coronary syndrome

    Authors

    Keywords

    lipoprotein(a), low-density lipoprotein cholesterol, acute coronary syndrome, chronic coronary syndrome

    DOI

    https://doi.org/10.15836/ccar2024.519

    Full Text

    **Background:** Independent of low-density lipoprotein cholesterol (LDL-C) levels, lipoprotein (a), or Lp(a), is a widely acknowledged biomarker for atherosclerosis and coronary artery disease. Studies have demonstrated the role of Lp(a) in the development of acute coronary syndrome (ACS), however it is unclear if Lp(a) could have a significant role in identifying those individuals who are at risk of developing chronic coronary syndrome (CCS). (1, 2) This study sought to investigate the association of Lp(a) and LDL-C levels with occurrence of acute and chronic coronary syndrome. **Patients and Methods**: We analyzed patients included in CaRD registry (NCT06090591) who underwent coronary angiography in Dubrava University Hospital between June 2024 and September 2024. Logistic regression analysis was conducted to investigate the association of higher Lp(a) and LDL-C levels with occurrence of ACS and CCS. A p value of 0.05 was regarded as statistically significant. **Results:** This registry-based study included 141 patients with a median age of 63 years (IQR 54-71). Male patients were more prevalent than female patients (77% vs 23%, respectively). Notably, women were more likely to display higher Lp(a) levels (p=.004). No statistically significant correlation of Lp(a) with age was observed, though older patients tend to have higher LDL-C value (p=.011). Patients with higher LDL-C levels were more likely to experience acute coronary syndrome (p=.005), while patients with higher Lp(a) levels more frequently presented with chronic coronary syndrome (p=.024). **Conclusion:** Based on results of our study, joined Lp(a) and LDL-C analysis might be invaluable tool in primary prevention setting, with the objective of distinguishing high-risk individuals who are more likely to present with CCS from those who are more likely to present with ACS. Additional research and larger sample sizes with longer follow-up are required to investigate the role of Lp(a) and LDL-C as markers of chronic and acute coronary syndrome, respectively.

    Literature

    1. Farzam K, Zubair M, Senthilkumaran S, Lipoprotein A. 2024 Feb 27. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. https://pubmed.ncbi.nlm.nih.gov/34033383/
    2. Liu HH, Li S, Zhang Y, Guo YL, Zhu CG, Wu NQ, et al. Joint Association of Lipoprotein(a) and a Family History of Coronary Artery Disease with the Cardiovascular Outcomes in Patients with Chronic Coronary Syndrome. J Atheroscler Thromb. 2024 September 1;31(9):1319–32. https://doi.org/10.5551/jat.64693
    Cardiologia Croatica
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    Lipoprotein(a) as a predictor of chronic coronary syndrome and low-density lipoprotein cholesterol as a predictor of acute coronary syndrome

    Extended Abstract
    Issue11-12
    Published
    Pages519
    PDF via DOIhttps://doi.org/10.15836/ccar2024.519
    lipoprotein(a)
    low-density lipoprotein cholesterol
    acute coronary syndrome
    chronic coronary syndrome

    Authors

    Dijana Bešić*ORCIDDubrava University Hospital, Zagreb, Croatia
    Petra BistrovićORCIDDubrava University Hospital, Zagreb, Croatia
    Tomislav ČikaraORCIDDubrava University Hospital, Zagreb, Croatia
    Klara PospišORCIDSpecial Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice, Croatia
    Sara VargaORCID”Dr. Ivo Pedišić” General Hospital, Sisak, Croatia
    Dominik BuljanORCIDDubrava University Hospital, Zagreb, Croatia
    Fran RodeORCIDDubrava University Hospital, Zagreb, Croatia
    Fran ŠalerORCIDDubrava University Hospital, Zagreb, Croatia
    Marko GalićORCID”Dr. J. Benčević” General Hospital, Slavonski Brod, Croatia
    Merljinda LjušajORCIDČakovec County Hospital, Čakovec, Croatia
    Marija RadićORCIDDubrava University Hospital, Zagreb, Croatia
    Marin ViđakORCIDDubrava University Hospital, Zagreb, Croatia
    Martina GodORCIDVaraždin General Hospital, Varaždin, Croatia
    Šime ManolaORCIDDubrava University Hospital, Zagreb, Croatia
    Ivana JurinORCIDDubrava University Hospital, Zagreb, Croatia

    *Correspondence email: dijana.besic94@gmail.com

    Full Text

    Background: Independent of low-density lipoprotein cholesterol (LDL-C) levels, lipoprotein (a), or Lp(a), is a widely acknowledged biomarker for atherosclerosis and coronary artery disease. Studies have demonstrated the role of Lp(a) in the development of acute coronary syndrome (ACS), however it is unclear if Lp(a) could have a significant role in identifying those individuals who are at risk of developing chronic coronary syndrome (CCS). (1, 2) This study sought to investigate the association of Lp(a) and LDL-C levels with occurrence of acute and chronic coronary syndrome.

    Patients and Methods: We analyzed patients included in CaRD registry (NCT06090591) who underwent coronary angiography in Dubrava University Hospital between June 2024 and September 2024. Logistic regression analysis was conducted to investigate the association of higher Lp(a) and LDL-C levels with occurrence of ACS and CCS. A p value of 0.05 was regarded as statistically significant.

    Results: This registry-based study included 141 patients with a median age of 63 years (IQR 54-71). Male patients were more prevalent than female patients (77% vs 23%, respectively). Notably, women were more likely to display higher Lp(a) levels (p=.004). No statistically significant correlation of Lp(a) with age was observed, though older patients tend to have higher LDL-C value (p=.011). Patients with higher LDL-C levels were more likely to experience acute coronary syndrome (p=.005), while patients with higher Lp(a) levels more frequently presented with chronic coronary syndrome (p=.024).

    Conclusion: Based on results of our study, joined Lp(a) and LDL-C analysis might be invaluable tool in primary prevention setting, with the objective of distinguishing high-risk individuals who are more likely to present with CCS from those who are more likely to present with ACS. Additional research and larger sample sizes with longer follow-up are required to investigate the role of Lp(a) and LDL-C as markers of chronic and acute coronary syndrome, respectively.

    Literature

    1. 1.
      Farzam K, Zubair M, Senthilkumaran S, Lipoprotein A. 2024 Feb 27. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–.PubMed
    2. 2.
      Liu HH, Li S, Zhang Y, Guo YL, Zhu CG, Wu NQ, et al. Joint Association of Lipoprotein(a) and a Family History of Coronary Artery Disease with the Cardiovascular Outcomes in Patients with Chronic Coronary Syndrome. J Atheroscler Thromb. 2024 September 1;31(9):1319–32.DOI