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Systemic inflammation modulates lipoprotein(a)-associated coronary stenosis in the chronic coronary syndromes

Lu Shen1,2, Wenqing Zhai1, Ping Jiang3

  • 1Department of Health Promotion and Behavioural Sciences, School of Public Health, Anhui Medical University, No.69 Meishan Road, Shushan District, Hefei, Anhui Province, China.

American Journal of Preventive Cardiology
|October 27, 2025
PubMed

Insights

Elevated lipoprotein(a) [Lp(a)] increases coronary stenosis risk, but only when systemic inflammation is low. Personalized therapies for chronic coronary syndromes (CCS) should consider inflammation levels for effective Lp(a) management.

Area of Science:

  • Cardiology
  • Inflammation Research
  • Vascular Biology

Background:

  • Lipoprotein(a) [Lp(a)] levels and associated cardiovascular risk are linked to systemic inflammation.
  • Investigating the role of systemic inflammation in modulating Lp(a)-associated coronary stenosis in chronic coronary syndromes (CCS) is crucial.

Purpose of the Study:

  • To determine if systemic inflammation influences the relationship between lipoprotein(a) and coronary stenosis severity in patients with chronic coronary syndromes.
  • To explore the impact of varying inflammation levels on Lp(a)-associated coronary artery disease risk.

Main Methods:

  • A retrospective, cross-sectional study of 1513 patients undergoing coronary angiography.
  • Patients were stratified by coronary stenosis severity using Gensini Scores and categorized by systemic inflammation levels (SIRI, SII, NLR).
  • Multinomial logistic regression models were employed to analyze the association between Lp(a) and stenosis under different inflammatory conditions.

Main Results:

  • Elevated Lp(a) was significantly associated with increased coronary stenosis risk (mild and severe) in the overall cohort.
  • This association was most pronounced in patients with low systemic inflammation (SIRI < 0.64), with significantly higher odds of mild and severe stenosis.
  • No significant association between Lp(a) and coronary stenosis was observed in patients with moderate or high systemic inflammation.

Conclusions:

  • The correlation between elevated lipoprotein(a) and coronary stenosis is contingent upon low systemic inflammation levels.
  • Personalized therapeutic strategies targeting Lp(a) in chronic coronary syndromes should incorporate assessments of the patient's inflammatory status for optimal management.
Abstract

Keywords:
Lipoprotein(a)·Coronary stenosis·Systemic inflammation ·Chronic coronary syndromes·Atherosclerosis

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