The correlation between lipoprotein(a) and coronary atherosclerotic lesion is stronger than LDL-C, when LDL-C is less than 104 mg/dL.
BACKGROUND
Lp(a) and LDL-C are both risk factors of atherosclerotic cardiovascular disease (ASCVD). But there was a contradiction point in LDL-C and Lp(a) control. The appropriate level of LDL-C and Lp(a) in the prevention of ASCVD is still pending.


OBJECTIVE
To investigate the correlation of Lp(a) and coronary atherosclerotic lesion, and find out the balance point in LDL-C and Lp(a) control.


METHOD
3449 patients were divided to coronary atherosclerotic heart disease (CAHD) Group and Non-CAHD Group based on the result of coronary angiography. The clinical characteristics were compared, and Logistic regressions were applied to find the CAHD risk factors in total, High-LDL-C Group (LDL-C ≥ 100 mg/dL) and Low-LDL-C Group (LDL-C < 100 mg/dL) patients. Spearman correlation analysis of Lp(a), LDL-C and Gensini Score was performed in patients with different LDL-C concentration.


RESULTS
Except male and diabetes, the traditional CAHD risk factors were well matched between two groups. But triglyceride, LDL-C and Lp(a) were higher, HDL-C and Apo-A1 were lower in CAHD group (2771). In the Logistic regression analysis, diabetes, LDL-C and Lp(a) are risk factors of CAHD in all patients, while in High-LDL-C Group, they were age, LDL-C, non-HDL-C and ApoB, in Low-LDL-C Group, they were age, Lp(a) and ApoB. Lp(a) correlated with Gensini with coefficient r = 0.41 in all patients, 0.67 in Low-LDL-C Group and 0.32 in High-LDL-C Group. The coefficient r for Lp(a) and Gensini decreased, while the r for LDL-C and Gensini increased with LDL-C concentration increasing. The two fitted lines of rs crossed at LDL-C = 2.7 mmol/L (104 mg/dL).


CONCLUSION
Lp(a) was the risk factor of CAHD in patients with LDL-C < 100 mg/dL. The correlation between Lp(a) and Gensini was influenced by LDL-C concentration, and the correlation was stronger than LDL-C when LDL-C < 104 mg/dl.
['Li|Chuang|C|', 'Chen|Qiwen|Q|', 'Zhang|Mei|M|0000-0002-8270-3513', 'Liu|Yin|Y|', 'Chu|Yushun|Y|', 'Meng|Fanpeng|F|', 'Wang|Jianyu|J|', 'Tang|Jie|J|', 'Luo|Jian|J|', 'Niu|Xiulong|X|', 'Wei|Maoti|M|']
D000368:Aged D015415:Biomarkers D008078:Cholesterol, LDL D017023:Coronary Angiography D003324:Coronary Artery Disease D023921:Coronary Stenosis D003430:Cross-Sectional Studies D050171:Dyslipidemias D005260:Female D006801:Humans D017270:Lipoprotein(a) D008297:Male D008875:Middle Aged D011379:Prognosis D018570:Risk Assessment D012307:Risk Factors D012720:Severity of Illness Index
Lipoprotein(a) Gensini score Acute coronary syndrome Low-density lipoprotein cholesterol