Lipoprotein(a) is associated with coronary atheroma progression: analysis from a serial coronary computed tomography angiography study  

作　　者：Xi WANG Dong-Kai SHAN Guan-Hua DOU Yi-Pu DING Jing JING He-Bin CHE Jun-Jie YANG Yun-Dai CHEN 

机构地区：[1]Medical School of Chinese PLA,Beijing,China [2]Department of Cardiology,the Sixth Medical Centre,Chinese PLA General Hospital,Beijing,China [3]Department of Cardiology,the Second Medical Centre,Chinese PLA General Hospital,Beijing,China [4]School of Medicine,Nankai University,Tianjin,China [5]Medical Big Data Research Centre,Chinese PLA General Hospital,Beijing,China

出　　处：《Journal of Geriatric Cardiology》2021年第12期996-1007,共12页老年心脏病学杂志（英文版）

基　　金：supported by the National Key Research and Development Program of China(2016YFC1300304);the Beijing NOVA Program(Z181100006218055).

摘　　要：BACKGROUND Lipoprotein(a)[Lp(a)]has been closely related to coronary atherosclerosis and might affect perivascular in-flammation due to its proinflammatory properties.However,there are limited data about Lp(a)and related perivascular inflam-mation on coronary atheroma progression.Therefore,this study aimed to investigate the associations between Lp(a)and the peri-vascular fat attenuation index(FAI)with coronary atheroma progression detected by coronary computed tomography angio-graphy(CCTA).METHODS Patients who underwent serial CCTA examinations without a history of revascularization and with available data for Lp(a)within one month before or after baseline and follow-up CCTA imaging scans were considered to be included.CCTA quantitative analyses were performed to obtain the total plaque volume(TPV)and the perivascular FAI.Coronary plaque pro-gression(PP)was defined as a≥10%increase in the change of the TPV at the patient level or the presence of new-onset coronary atheroma lesions.The associations between Lp(a)or the perivascular FAI with PP were examined by multivariate logistic regres-sion.RESULTS A total of 116 patients were ultimately enrolled in the present study with a mean CCTA interscan interval of 30.80±13.50 months.Among the 116 patients(mean age:53.49±10.21 years,males:83.6%),32 patients presented PP during the follow-up interval.Lp(a)levels were significantly higher among PP patients than those among non-PP patients at both baseline[15.80(9.09−33.60)mg/dL vs.10.50(4.75−19.71)mg/dL,P=0.029]and follow-up[20.60(10.45−34.55)mg/dL vs.8.77(5.00−18.78)mg/dL,P=0.004].However,there were no differences in the perivascular FAI between PP group and non-PP group at either baseline or follow-up.Multivariate logistic regression analysis showed that elevated baseline Lp(a)level(OR=1.031,95%CI:1.005−1.058,P=0.019)was an independent risk factor for PP after adjustment for other conventional variables.CONCLUSIONS Lp(a)was independently associated with coronary atheroma progression beyond low-density lipop

关 键 词：Lp(a) CORONARY ELEVATED 

分 类 号：R541.4[医药卫生—心血管疾病]