Association of high-sensitivity C-reactive protein and lipoprotein-associated phospholipase A₂ with coronary artery...

To evaluate the associations of high-sensitivity C-reactive protein (hs-CRP) and lipoprotein-associated phospholipase A₂ (Lp-PLA₂) with coronary lesion severity in patients undergoing coronary angiography, and to clarify their respective clinical utility.

A total of 438 hospitalized patients who underwent coronary angiography in the Department of Cardiology of the First Affiliated Hospital of Henan University of Science & Technology between April 2023 and April 2024 were retrospectively analyzed. Based on the extent of coronary artery stenosis, participants were divided into a CHD group (stenosis ≥50%, n = 329) and a control group (stenosis <50%, n = 109). General clinical data and laboratory indicators, including Lp-PLA₂ and hs-CRP levels, were collected and compared between groups. Independent risk factors for CHD were analyzed using binary logistic regression. Receiver operating characteristic curve analysis was conducted to evaluate the diagnostic discrimination (area under the curve) of each biomarker for concurrent assessment of lesion severity. Statistical analysis was performed using SPSS 27.0. Continuous data were compared using t-tests or nonparametric tests; categorical data were compared with χ² tests. Correlation and multivariate logistic regression analyses were conducted, and ROC curves assessed biomarker diagnostic discriminatory utility. p<0.05 was considered statistically significant.

Serum levels of both Lp-PLA₂ and hs-CRP demonstrated a significant association with the severity of coronary artery lesions. Lp-PLA₂ levels increased in correlation with the number of affected vessels, reaching the highest levels in individuals with three-vessel disease. Conversely, hs-CRP levels were highest among those with two-vessel disease. Participants with acute myocardial infarction exhibited higher levels of both biomarkers compared to those with stable or unstable angina (all p < 0.05). Lp-PLA₂ demonstrated excellent diagnostic discrimination for CHD (AUC = 0.900) and severe coronary lesions (AUC = 0.952). While the incremental gain of combined hs-CRP assessment was modest (ΔAUC = 0.007, p = 0.427), the dual-marker approach provides complementary inflammatory information for risk stratification.

The combined evaluation of Lp-PLA₂ and hs-CRP provides clinically meaningful diagnostic discriminatory information regarding the severity of coronary artery lesions. This dual-marker approach was associated with coronary lesion severity in individuals undergoing coronary angiography in this retrospective cohort.