Lipoprotein(a) and lipid profiles of patients awaiting coronary artery bypass graft; a cross sectional study

Abstract

BackgroundLipoprotein(a) (Lp(a)) excess is an independent risk factor of coronary artery disease (CAD) and have shown wide ethnic variations. Further, lipid parameters used in the assessment and management of risk factors for CAD may not reflect accurately the disease or severity if the patients are on pharmacological interventions when compared to Lp(a). Lp(a) levels of Sri Lankan CAD patients awaiting coronary artery bypass graft are not documented.MethodsA cross sectional study was carried out with patients (n = 102) awaiting coronary artery bypass graft at a tertiary healthcare institution in Sri Lanka. Lp(a) was determined by immunoturbidimetric method (Konelab 20XT) and information on risk factors collected using a standardized questionnaire. The severity of CAD was determined by Gensini score. Lipid parameters and pharmacological treatment data were obtained from the Medical Records. Data were analysed using independent sample t-test, Pearson and Spearman tests respectively.ResultsTotal cholesterol (TC), LDL cholesterol (LDLc) and HDL cholesterol (HDLc) of the total study sample (average ± SD) were, 150 ± 36 mg/dL, 92 ± 36 mg/dL and 34 ± 9 mg/dL respectively with no significant difference irrespective of being on pharmacological treatment or not. All lipid parameters were significantly high (p < 0.05) in females. The average Lp(a) was 50 ± 38 (SD) mg/dL with no significant difference in males or females independent of being on treatment (50 ± 39 mg/dL) or not (49 ± 39 mg/dL) and above the cut off value (30 mg/dL).ConclusionsDespite pharmacological interventions 27 % of the study population had high LDLc and majority low HDLc. Mean Lp(a) was in excess irrespective of risk factors or being on treatment or not and is confirmed as an independent, potential marker for assessing the susceptibility for CAD especially in those with other intermediate risk factors but considered non-hyperlipidemic by conventional methods.

Lipid Profiles and Framingham Risk Score in Patients with Coronary Artery Bypass Graft Surgery undergoing Cardiac Rehabilitation Program

“…Homocysteine, fibrinogen, lipoprotein(a), low density lipoprotein particle size and C-reactive protein are additional risk factors for the onset of CVD [6].…”

Prevalence and association of thyroid disorders with selected risk factors and severity of disease in patients confirmed of Coronary Artery Disease

“…In the present study Lp(a) concentration was not significantly different between euthyroid and SCH individuals. Thus compared to lipid parameters, elevated Lp(a) singles out as an independent risk factor 39 .…”