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Predictive effect of different blood lipid parameters combined with carotid intima-media thickness on coronary artery

Bingyan Yu1,2, Ying Wu2, Wei Li3

  • 1School of Medicine, South China University of Technology, Guangzhou, China.

Frontiers in Cardiovascular Medicine
|January 30, 2023
PubMed

Insights

Lipoprotein (a) [Lp (a)], combined with carotid intima-media thickness (cIMT), is a superior predictor of coronary artery disease (CAD) compared to other blood lipid markers. Elevated Lp (a) also indicates multi-vessel CAD.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Diagnostics
  • Biomarker Research

Background:

  • Blood lipid disorders and atherosclerosis are significant risk factors for coronary artery disease (CAD).
  • Accurate prediction of CAD is crucial for timely intervention and management.
  • Carotid intima-media thickness (cIMT) is an established marker of subclinical atherosclerosis.

Purpose of the Study:

  • To compare the efficacy of various blood lipid parameters, alone and in combination with cIMT, for predicting CAD.
  • To evaluate the predictive value of lipoprotein (a) [Lp (a)] in relation to other lipid profiles.
  • To assess the association between Lp (a) levels and the severity of CAD (multi-vessel involvement).

Main Methods:

  • Retrospective analysis of patients undergoing coronary angiography for suspected CAD.
  • Lipid profile analysis and carotid ultrasound for cIMT measurement.
  • Logistic regression and receiver operating characteristic (ROC) curve analysis (Area Under the Curve - AUC) to assess predictive performance.

Main Results:

  • Patients with CAD exhibited higher levels of Lp (a), apolipoprotein B/apolipoprotein A, total cholesterol/HDL-C, triglyceride/HDL-C, and LDL-C/HDL-C compared to non-CAD patients.
  • Lp (a) combined with cIMT demonstrated the highest AUC (0.713) for CAD prediction, outperforming other lipid parameters.
  • Elevated Lp (a) levels were significantly associated with multi-vessel CAD (OR: 1.41, 95% CI: 1.02-1.95).

Conclusions:

  • Lp (a) significantly enhances CAD prediction, particularly when LDL-C levels are not elevated.
  • Lp (a) serves as a valuable biomarker for predicting the presence and severity of CAD.
  • The combination of Lp (a) and cIMT offers a robust approach for CAD risk stratification.
Abstract

Keywords:
blood lipid indicescarotid intima-media thicknesscarotid ultrasoundcoronary artery diseaselipoprotein (a)

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