Effect of lipoprotein(a) level on plaques characteristics in coronary artery lesions- from optical coherence tomography image

Liu Zesen; Zhang Chaoyi; Zhang Tingyu; Li Yuntao; Lin Jie; Meng Kang

doi:10.3969/j.issn.1674-4055.2019.05.24

Abstract：Objectives To investigate the relationship between the level of lipoprotein (a) and the characteristics of intravascular plaque in coronary artery patients with coronary heart disease, and to analyze the effect of lipoprotein (a) level on the stability of lipid plaque. Methods A total of 95 patients who underwent coronary angiography and OCT in Beijing Anzhen Hospital from January 2015 to December 2017 were retrospective analyzed. According to preoperative lipoprotein (a) levels, there were 34 cases of hyperlipoprotein(a) group (≥30 mg/dl) and 61 cases of normal control group (＜30 mg/dl). The clinical data and OCT examination results were retrospectively analyzed. Results A total of 111 criminal blood vessels were analyzed, including 40 vessels of hyperlipoprotein(a) group. The total number of plaques on each criminal coronary artery (2.60±1.06 vs. 2.10±1.06), the number of fibrous plaques on each criminal coronary artery (1.48±0.72 vs. 1.08±0.75) and the detection rate of calcified plaques (62.50% vs. 40.85%) was significantly higher than that in the normal group (P<0.05). A total of 108 intravascular lipid plaques. were analyzed, including 42 of hyperlipoprotein(a) group. The maximum lipid arc of lipid plaques (182.21±66.29 vs. 136.67±45.6), the mean lipid arc (139.18±46.89 vs. 108.00) ±31.41, P<0.001), and the lipid index (787.88±67.6 vs. 510.92± 387.72) was significantly higher than the normal group (P<0.05), while the thinnest fibrous cap thickness (84.05± 32.91 vs. 99.85±36.18) was significantly lower. Multiple logistic regression analysis showed that elevated levels of lipoprotein (a) were independently related to the number of fibrous plaques in criminal’s coronary, the maximum lipid arc of lipid plaques, the mean lipid arc, and the detection rate of calcified plaques. Conclusions The lipid plaques of coronary artery lesions in patients with hyperlipoprotein(a) are more unstable. Lipoprotein(a)is an independent risk factor for the number of fibrous plaques, the maximum lipid core angle of lipid plaques and the increase in mean lipid core angle in the culprit vessels of coronary heart disease patients. At the same time, for every 10 mg/dl increase in lipoprotein (a) levels, the probability of calcified plaques in the culprit vessels will increase by 23%.