<p>The Association of Syntax Score with Levels of Lipoprotein(a) and Inflammatory Biomarkers in Patients with Stable Coronary Artery Disease and Different Low-Density Lipoprotein Cholesterol Levels</p>

Abstract

Introduction Lipoprotein(a) (Lp(a)) is associated with the severity of coronary lesions evaluated using Syntax score in patients with stable coronary artery disease (CAD). However, the effect of low-density lipoprotein cholesterol (LDL-C) levels on the association of Lp(a) levels with Syntax score remains unclear. Methods A total of 646 patients with stable CAD were enrolled in the present study. Lp(a) levels were measured with an AU5800 Chemistry Analyzer. Syntax scores were calculated by two advanced interventional cardiologists. SPSS 22.0 was used for statistical analyses. Results The concentration of Lp(a) ranged from 1 to 192 mg/dL. Pearson’s correlation analysis showed a positive correlation between Syntax score and the level of Lp(a) (r = 0.108, p = 0.006). The LDL-C ≥100 mg/dL group presented with a higher Lp(a) level, 16 (9–29) vs 13 (7–24). Pearson’s correlation analysis identified a correlation between Lp(a) level and Syntax score (r = 0.249, p < 0.001) only in the LDL-C ≥100 mg/dL group. Multivariate logistic regression analysis revealed the positive predictive value of an Lp(a) level >30 mg/dL for a Syntax score ≥23 only in the LDL-C ≥100 mg/dL group, adjusted odds ratio 2.895, p = 0.010. A receiver operating characteristic curve analysis confirmed the predictive value of Lp(a) levels for a Syntax score ≥23 in the LDL-C ≥100 mg/dL group with a cutoff value for Lp(a) >30 mg/dL. Discussion The association between Lp(a) level and Syntax score was only maintained in the LDL-C ≥100 mg/dL group. An Lp(a) level >30 mg/dL was an independent predictor of a Syntax score ≥23 only in the LDL-C ≥100 mg/dL group. The effect of LDL-C levels on the association of Lp(a) levels with Syntax score requires further investigations.

Vascular smooth muscle cells in low SYNTAX scores coronary artery disease exhibit proinflammatory transcripts and proteins correlated with IL1B activation

“…Previously published works demonstrated conflicting correlations between inflammatory markers and SS that may be confounded by the presence of other CAD risk factors [43][44][45]. Our well-matched (lipid levels and other CAD risk factors) samples with different SS may have enabled us for a more precise identification of inflammatory dysfunctions in CAD patients.…”

Redox Status and Telomere–Telomerase System Biomarkers in Patients with Acute Myocardial Infarction Using a Principal Component Analysis: Is There a Link?

“…A standard lipid panel containing high levels of TG, high non-high-density lipoprotein cholesterol (non-HDL-C) and low HDL-cholesterol (HDL-C) is correlated to a high risk of CVD. More comprehensive lipid testing identified an increased levels of small dense LDL particles and remnant lipoproteins as particularly atherogenic ones [ 42 ]. Moreover, Xu’s research group reported the association of Lp(a) level with SYNTAX score, which was maintained for the group with LDL-C values over 100 mg/dL (2.586 mmol/L) [ 42 ].…”

“…More comprehensive lipid testing identified an increased levels of small dense LDL particles and remnant lipoproteins as particularly atherogenic ones [ 42 ]. Moreover, Xu’s research group reported the association of Lp(a) level with SYNTAX score, which was maintained for the group with LDL-C values over 100 mg/dL (2.586 mmol/L) [ 42 ].…”

Are we seeing the light at the end of the tunnel for high lipoprotein(a)? Lipoprotein(a)

“…Furthermore, in individuals with established ST-elevation MI, very high (>135 mg/dL) levels of Lp(a) can predict the worse long-term outcomes as proven by the prospective cohort studies, highlighting the need for Lp(a)-based risk stratification in these patients (39). Combining Lp(a) with other risk estimates such as fibrinogen, Syntax Score etc have been shown to increase the prediction of cardiovascular events in acute or chronic ASCVD states (40,41). Even slightly elevated Lp(a) levels may result in early loss of vein grafts in the first year of the coronary artery bypass grafting surgery (42) Lp(a) levels have been shown predict mid and long term ASCVD events in patients undergoing percutaneous coronary intervention (PCI) (43).…”