Gender differences in lipoprotein(a) levels among patients with acute coronary syndrome in a tertiary hospital in our city: a cross-sectional study

Introduction Serum lipoprotein(a) [Lp(a)] has been considered an important biomarker of atherosclerotic cardiovascular disease. While large trials such as ODYSSEY OUTCOMES have demonstrated the prognostic value of comprehensive apolipoprotein profiling including ApoB, ApoC-III, and Lp(a) in post-acute coronary syndrome (ACS) patients, data from Central Asian populations remain scarce. Our study was performed in a tertiary hospital in our city, Kyrgyzstan. Nevertheless, there is a shortage of studies on Lp(a) together with ApoC and ApoB in this population. Aim of the study To investigate the possible association of Lp(a) with ApoC and ApoB and the severity of coronary stenosis in patients with acute coronary syndrome. Methods A cross-sectional study was conducted on patients with ACS to evaluate the association of serum Lp(a) with ApoB, total ApoC, and the severity of coronary stenosis. The diagnosis of ACS was confirmed by appropriate ECG signs and elevated serum troponin. Blood samples for measurement of Lp(a) (nmol/L), ApoB (mg/dL), and ApoC (mg/dL) were collected within 24 hours of admission. All patients with ACS underwent coronary angiography with percutaneous coronary intervention (PCI) in a tertiary hospital. Stenosis severity was assessed as the percentage of diameter stenosis in major epicardial coronary vessels (left anterior descending, left circumflex, right coronary artery, and left main coronary artery). Written informed consent for participation in the study was obtained from all participants. The study protocol was approved by the local Bioethics Committee. SPSS version 16.0 was used for statistical analysis. Data were presented as Me (25th; 75th percentiles). Statistical significance was considered at p < 0.05. Results A total of 90 patients (69 men, 21 women) with ACS were included, with a median age of 56.5 (51; 63) years overall: 54 (47; 61) years for men and 60 (58; 65) years for women (p < 0.001). The median Lp(a) level was 3.0 (1.32; 10.9) nmol/L overall: 3.3 (1.4; 11.7) nmol/L in men and 1.37 (1.1; 3.14) nmol/L in women (p < 0.05). The median ApoB level was 27.1 (21.1; 33.1) mg/dL overall: 26.8 (21.5; 33.1) mg/dL in men and 27.3 (21.1; 32.9) mg/dL in women, with no significant difference. The median ApoC level was 659.1 (141.5; 887.5) mg/dL overall: 665.9 (141.5; 838.6) mg/dL in men and 592.0 (152.9; 895.4) mg/dL in women (not significant). Correlation analysis revealed that Lp(a) correlated with gender: r = 0.247; p < 0.05. Lp(a) was not correlated with the percentage of stenosis in major coronary vessels. Coronary angiography was performed within the first 2 hours of admission with evaluation of stenosis severity. Conclusion Lp(a) levels in patients with ACS were significantly higher in men than in women. However, no association was confirmed between Lp(a) and ApoB, ApoC, or the percentage of stenosis in major coronary vessels. Further, larger-scale prospective studies are needed in the future.