Lipoprotein(a) is associated with coronary atheroma progression:analysis from a serial coronary computed tomography angiography study
Xi WANG1
Dong-Kai SHAN2
Guan-Hua DOU3
Yi-Pu DING4
Jing JING2
He-Bin CHE5
Jun-Jie YANG2
Yun-Dai CHEN2
1.Medical School of Chinese PLA,Beijing,China;Department of Cardiology,the Sixth Medical Centre,Chinese PLA General Hospital,Beijing,China2.Department of Cardiology,the Sixth Medical Centre,Chinese PLA General Hospital,Beijing,China3.Department of Cardiology,the Second Medical Centre,Chinese PLA General Hospital,Beijing,China4.School of Medicine,Nankai University,Tianjin,China5.Medical Big Data Research Centre,Chinese PLA General Hospital,Beijing,China
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 lipoprotein cholesterol and other conventional risk factors. Further studies are warranted to identify the inflammation effect exhibited as the perivascular FAI on coronary atheroma progression.
机标关键词：tomographyangiographyserialcomputedanalysisstudywithfrom
论文发表日期：2021-12-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：12( 996-1007 )