Impact of Serum Lipoprotein (A) Level on Coronary Artery Calcification: An Intravascular Ultrasound Study

Abstract Background Plasma lipoprotein(a) [Lp(a)] participates in the development of coronary heart disease (CAD). However, the relationship between Lp(a) level and the characteristic of coronary artery calcification has not been investigated. Methods A total of 123 patients with CAD who underwent percutaneous coronary intervention(PCI) were analyzed.Calcification burden of coronary culprit plaque was measured by the angle and thickness with intravascular ultrasound imaging(IVUS). Patients were divided into 2 groups: low Lp(a) group, < 150mg/L; high Lp(a) group, ≥ 150mg/L. Results Mean patient age was 62.6 ± 10.1years, and 75.6% were men. Among 139 lesions, compared with the high Lp(a) group, the low Lp(a) group had significantly greater median maximum calcification angle (166.4°[102.1, 260.5] vs 118.4° [83.4,169.7], P = 0.007) and thick calcification(40.7% vs 21.2%, P = 0.013).Plaques with a maximum calcification angle of ≥ 180° were more frequently observed in the low Lp(a) group (42.6% vs 18.8%, P = 0.002).The calcification lesions of maximum arc ≥ 180° +thick calcification were larger in the low Lp(a) group (35.2% vs 11.8%, P = 0.001). Multivariate logistic regression analysis showed that low Lp(a) level was a independent predictor of a greater calcification burden: calcification arc ≥ 180°(OR 4.43, 95%CI1.93-10.13;P < 0.001),and thick calcification + maximum calcification arch ≥ 180°(OR 5.92, 95% CI 2.36–14.82; P < 0.001). Conclusion In patients with CAD, Low Lp(a) level was associated with high burden of coronary artery calcification. Our findings might provide a new perspective of Lp(a) level on plaque-stabilizing effects in coronary atherosclerotic plaque.