The Association Between Lipoprotein(a) and Atherosclerotic Cardiovascular Disease Severity

Background: Lipoprotein(a) (Lp(a)) has emerged as an independent determinant of risk among the multiple factors associated with atherosclerotic cardiovascular disease. This study, which utilized data from the northern Chinese population, aimed to investigate the association between Lp(a) and conventional coronary heart disease risk factors. Furthermore, the Lp(a) level may reflect the severity of vascular stenosis in individuals affected by coronary heart disease, offering valuable insights for future clinical interventions. Methods: A total of 778 individuals who underwent coronary angiography and were later confirmed to have coronary artery disease from September 2022 to December 2024 participated in this study. Baseline clinical information collected for each participant included sex, age, height, weight, smoking and drinking habits, history of hypertension, diabetes status, lipid parameters, and other pertinent medical characteristics. Result: The analysis demonstrated that progressive increases in circulating Lp(a) levels were associated with a pronounced escalation in vascular stenosis, a pattern reaching statistical significance (p < 0.05). An evaluation of the receiver operating characteristic (ROC) curve indicated that Lp(a) yielded an area under the curve (AUC) value of 0.673 (95% confidence interval (CI): 0.630–0.716; p < 0.001) for identifying severe coronary artery stenosis. A significant correlation (r = 0.306; p < 0.0001) was revealed in the assessment of the correlation between Lp(a) and the Gensini score. An independent association was observed between Lp(a) levels and the number of diseased coronary arteries (odds ratio (OR) = 1.029, 95% CI: 1.017–1.041; p < 0.001). Furthermore, individuals with higher Gensini scores exhibited significantly increased Lp(a) levels. Notably, patients with chronic total occlusion (CTO) lesions or multi-vessel disease also demonstrated markedly higher Lp(a) levels (all p values < 0.001). Conclusion: Elevated Lp(a) concentrations are linked to increased severity of coronary heart disease, as evidenced by higher Gensini scores. Elevated Lp(a) concentrations are also associated with an increased occurrence of multi-vessel coronary artery stenosis or total occlusions.