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Lipoprotein(a) Lp(a) is associated with coronary artery disease due to its atherogenic and thrombogenic nature. In this study, we aimed to compare the level of Lp(a) in young and middle-aged patients with ST-elevation myocardial infarction (STEMI). This retrospective study included 287 patients aged 20-65 years who presented to the emergency department for the first time due to STEMI. The patients were divided into two groups: 20-45 years (young group, n = 111) and 46-65 years (middle-aged group, n = 176). The groups were compared in terms of demographic characteristics, co-morbidities and laboratory findings. In the young group, smoking (99, 89.2% vs 130, 73.9%; p = 0.001), family history of coronary artery disease (75, 67.6% vs 80, 45.5; p < 0.001), serum Lp(a) level 38.1 ± 27.9 (93 ± 68) vs 23.5 ± 23.2 mg/dl (57 ± 56 nmol/l); p < 0.001, triglyceride level [219.1 ± 231.9 (2.48 ± 2.62) vs 170.2 ± 105.6 mg/dl (1.92 ± 1.19 mmol/l); p = 0.018), ejection fraction (52.4 ± 6.1 vs 47.2 ± 7.7%; p = 0.004) and single-vessel disease (83, 74.8% vs 110, 62.5%; p = 0.031) were higher than in the middle-aged group. In multivariable logistic regression analyses, family history (OR: 2.073, 95% CI: 1.210-3.549; p = 0.008), low high-density lipoprotin cholesterol level (OR: 1.032, 95% CI: 1.003-1.062; p = 0.029) and Lp(a) elevation (OR: 1.981, 95% CI: 1.871-3.991; p < 0.001) were possible independent risk factors for STEMI in young patients. Lp(a) level was found to be a higher and a possible independent risk factor in young patients who presented with STEMI for the first time, compared to the middle-aged patient group. Lp(a) is a highly atherogenic molecule and it has been associated with stroke, heart failure, aortic stenosis, as well as coronary artery disease. Measurement of Lp(a) levels may be recommended in young patients with high cardiovascular risk.
Usalp et al. (Tue,) studied this question.