ABSTRACT Background: Lipoprotein(a) (Lpa), a curious lipoprotein particle consisting of a lipid-rich apolipoprotein (apo) B lipoprotein with an apo(a) moiety, is a molecule of burgeoning interest in the cardiovascular community due to its postulated association with atherosclerotic cardiovascular diseases. We try to look into the influence of Lp(a) level in patients presenting with acute coronary syndrome (ACS) in our institute, Jawaharlal Nehru Institute of Medical Sciences. Materials and Methods: We enrolled 100 consecutive subjects aged 18 years and above presenting with ACS in a tertiary healthcare center in Manipur. Human Lp(a) assay and fasting lipid profile were measured. Detailed clinical characteristics, management, and hospital course were recorded. Human Lp(a) assay was done using an enzyme-linked immunosorbent assay ELISA kit (assay max human Lpa kit-Assaypro). Lp(a) level with clinical characteristics, lipid parameters, and treatment outcome were studied. Results: This cross-sectional study enrolled 100 consecutive ACS patients, comprising 68% males and 32% females. The mean age of the study population was 59 ± 13.8 years, with 30% between the ages of 50 and 60 years. The majority of ACS were ST elevated myocardial infarction (70%), with non-ST-elevation myocardial infarction 26% and USA 4%. The mean Lp(a) level in males and females was 35.9 ± 18.6 and 28.7 ± 19.4 mg/dL, with no significant difference ( P = 0.206). A total of 51% of the ACS population had Lp(a) level >30 mg/dL. Additionally, 45% of the study population had Lp(a) levels in the third quartile, between 26 and 75 mg/dL. Around 46% of the study population had dyslipidemia, contributed mainly by low–high-density lipoproteins. Only 22% had high–low-density lipoprotein (LDL) level > 130 mg/dL. There was no statistically significant interaction between Lp(a) level and studied clinical characteristics, types of ACS, lipid parameters, and outcome. Conclusion: Our study shows the potential important contribution of Lp(a) molecule in atherogenic lipid burden other than LDL in ACS patients and probably the residual risk in recurrent cardiovascular events on statins. It may be a good candidate for screening in this modern era of preventive cardiology.
Thangjam et al. (Mon,) studied this question.