The effect of lipoprotein (a) elevation on coronary flow reserve

Lipoprotein (Lp)(a) is a genetically inherited lipoprotein implicated in the progression of cardiovascular diseases and atherosclerosis. This study aims to examine whether elevated Lp(a) levels contribute to the development of subclinical atherosclerosis, compared to individuals with normal Lp(a) levels, using parameters such as coronary flow reserve (CFR).

The study population included 25 patients with elevated Lp(a) levels and 30 subjects with normal Lp(a) levels, recruited prospectively. Conventional echocardiographic measurements were performed according to established guidelines. Main outcome measures included the comparison of CFR values between the groups.

The CFR was found to be significantly decreased in the group with elevated Lp(a) levels compared to the control group (2.0 ± 0.5 vs. 2.5 ± 0.6, p < 0.001). Additionally, a negative and statistically significant correlation was observed between Lp(a) levels and CFR, indicating that higher Lp(a) levels are associated with lower CFR values (r: -0.657, p < 0.001).

Our study demonstrates that elevated Lp(a) levels are significantly associated with subclinical atherosclerosis and impaired coronary vasomotor function. These findings suggest that lowering Lp(a) levels could effectively reduce the risk of atherosclerotic disease by targeting its role in atherosclerosis pathogenesis.