Coronary calcification is associated with elevated serum lipoprotein (a) levels in asymptomatic men over the age of 45 years

Abstract

Lipoprotein a (Lp (a)) and coronary artery calcification (CAC) are markers of coronary artery and cardiovascular diseases. However, the association between Lp (a) and CAC in asymptomatic individuals remains unclear. In this study, we aimed to determine the influence of Lp (a) on CAC in asymptomatic individuals. We included 2019 asymptomatic Korean adults who underwent testing for a coronary artery calcium score (CACS) and Lp (a) at the Gangnam Severance Hospital Health Checkup Center in Korea from January 2017 to August 2019. Participants were divided into 2 groups: CACS = 0 and CACS > 0. Factors affecting the CACS were analyzed by sex. Because age is a major risk factor for atherosclerosis, ≥45 years in men and ≥55 years in women, we further divided participants into 4 subgroups (≥45 and <45 in men, ≥55 and <55 in women). Factors affecting the CACS in the 4 groups were analyzed. There was a positive correlation between the CACS and traditional cardiovascular risk factors. Lp (a) positively correlated with the CACS in men ( P < .01) and remained significant after multivariable logistic regression ( P < .01). The same result was observed in men aged ≥45 years ( P < .01). Lp (a) is an independently associated factor of CAC and a marker of coronary atherosclerosis in asymptomatic men aged ≥45 years. In asymptomatic men aged ≥45 years, Lp (a) should be measured, and intensive Lp (a)-lowering treatment should be considered.

Subclinical cardiovascular disease and utility of coronary artery calcium score

“…Y. H. Chung [166] including 2019 participants (M:1518 (75.2%), F:501 (24.8%)) in cross-sectional analysis on relation between CACs and Lp(a), which was noted with its composition of apoB-100 and apolipoprotein(a) bounded in disulfide bond, it‘s small-particle size allowing freely crossing endothelium, similarity of apo(a) with plasminogen interfering it‘s antithrombotic actions and a moiety in Lp(a) closely resembling LDL; revealed among males aged ≥ 45 years (1313 participants, 86.4% of Males) those with CACs > 0 vs CACs = 0 had higher Lp(a) level by chi-square test (16.74 vs 13.97) and Lp(a) level significantly associated with having CACs > 0 by both univariable (OR:1.008, 95% CI:1.003–1.014) and multivariable models (OR:1.010, 95% CI:1.004–1.016), however, among males aged < 45 years and females aged either < 55 years or ≥ 55 years Lp(a) levels couldn‘t reach significant trend with having CACs > 0 by univariable and multivariable analyses, nevertheless, those with Lp(a) > 50 mg/dL vs Lp(a) 15–30 had significantly higher CACs by Kruskal-Wallis test.…”

Correlations Between Coronary Artery Disease, Coronary Artery Calcium Score, and Lipoprotein(a) Level in Korea

“…The study of Chung et al showed that in asymptomatic male patients over 45 years of age, the level of Lp(a) was significantly higher for patients with CAC scores greater than 0 than the Lp(a) level of patients with CAC scores of 0 (16.74 ± 20.53 vs 13.97 ± 16.10, p = 0.006). 18 Sung et al 19 also demonstrated a positive correlation between Lp(a) level and CAC score in a large cohort in Korea. However, unlike our study, these two studies were conducted on asymptomatic health check-up patients, and the cut-off of the patients’ CAC scores was much lower than that in our study (0 vs 400).…”

The LDL-C/Apo B predicts coronary atherosclerotic heart disease in non-diabetic patients without high LDL-C

“…[ 14 , 15 ] CACS > 0 was defined as detectable coronary artery calcium. [ 16 ] After CCTA evaluation, coronary revascularization (percutaneous coronary intervention or coronary artery bypass graft [CABG]) was performed according to the discretion of the attending physician. The coronary revascularization rate was also investigated.…”