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January 1, 2003Yonsei Medical JournalOpen Access

The risk of ACS was higher in patients with both CAC and elevated Lp(a) than in those with only one (OR: 2.16, 95% CI 1.213 - 3.843, p=0.009); Lp(a) was an independent risk factor in patients <60 years, while CAC was an independent risk factor in patients >60 years.

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Why the study?

Do elevated Lp(a) and coronary artery calcification increase the risk of acute coronary syndrome in patients with coronary artery obstructive disease?

Population

698 patients diagnosed with at least minimal coronary artery obstructive disease from a coronary angiography

Comparison

Elevated Lp and/or presence of coronary artery… vs Normal Lp and/or absence of coronary artery…

Design

Cross-sectional

Authors

SRSung Kee RyuBHBum‐Kee HongHKHyuck Moon Kwon

Discussion

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Member takes

Overview

May support combined Lp(a)-CAC risk stratification in obstructive CAD; leaves open whether targeting both reduces ACS events.

Structured PICO

Do elevated Lp(a) and coronary artery calcification increase the risk of acute coronary syndrome in patients with coronary artery obstructive disease?

P
Population
698 patients diagnosed with at least minimal coronary artery obstructive disease from a coronary angiography
I
Intervention
Elevated Lp(a) (> 35 mg/dl) and/or presence of coronary artery calcification (CAC)
C
Comparator
Normal Lp(a) (≤ 35 mg/dl) and/or absence of coronary artery calcification
O
Outcome
Diagnosis of Acute Coronary Syndrome (ACS)hard clinical

Elevated Lp(a) and coronary artery calcification have a synergistic effect on the risk of acute coronary syndrome, with Lp(a) being a more potent risk factor in younger patients and CAC in older patients.

Cite This Study

Ryu et al. (2003) studied this question.

synapsesocial.com/papers/6a7ec6ce366dd125a6c30452https://doi.org/10.3349/ymj.2003.44.3.445
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Association of advanced coronary artery calcification assessed by coronary artery calcium scoring with lipoprotein (a) and carotid atherosclerosis in asymptomatic patients2026
  2. 2The Association of Lipoprotein(A) and Coronary Artery Calcium in Primary Prevention Patients—Data from the STAR-Lp(A) Study2025 · 2 citations
  3. 3Coronary calcification is associated with elevated serum lipoprotein (a) levels in asymptomatic men over the age of 45 years2021 · 21 citations
  4. 4Elevated Lipoprotein(a) and Adverse Outcomes in Advanced Coronary Artery Calcification: An Intravascular Ultrasound Study2026 · 2 citations
  5. 5Association of lipoprotein(a) with coronary plaque progression in patients with acute coronary syndrome assessed by optical coherence tomography2025