Lipoprotein (a) is related to coronary atherosclerotic burden and a vulnerable plaque phenotype in angiographically obstructive coronary artery disease

Giampaolo Niccoli, Diana Cin, Giancarla Scalone, Mario Panebianco, Sofia Abbolito, Nicola Cosentino, Francesca Jacoangeli, Hesham Refaat, Giovanna Gallo, Gerardo Salerno, Massimo Volpe, Filippo Crea, Luciano De Biase

Risultato della ricerca: Contributo in rivistaArticolo in rivista

16 Citazioni (Scopus)

Abstract

Background: Lipoprotein Lp(a) has been shown to be an independent risk factor for coronary artery disease (CAD). However, its association with CAD burden in patients with ACS is largely unknown, as well as the association of Lp(a) with lipid rich plaques prone to rupture. Aim: We aim at assessing CAD burden by coronary angiography and plaque features including thin cap fibroatheroma (TCFA) by optical coherence tomography (OCT) in consecutive patients presenting with acute coronary syndrome (ACS) and obstructive CAD along with serum Lp(a) levels. Methods: This study comprises an angiographic and an OCT cohort. A total of 500 ACS patients (370 men, average age 66 +/- 11) were enrolled for the angiographic cohort and 51 ACS patients (29 males, average age 65 +/- 11) were enrolled for the OCT cohort. Angiographic CAD severity was assessed by Sullivan score and by Bogaty score including stenosis score and extent index. OCT plaque features were evaluated at the site of the minimal lumen area and along the culprit segment. Results: In the angiographic cohort, at multivariate analysis, Lp(a) was a weak independent predictor of Sullivan score (p < 0.0001), stenosis score (p < 0.0001) and extent index (p < 0.0001). In the OCT cohort, patients with higher Lp(a) levels (-30 md/ dl) compared to patients with lower Lp(a) levels (< 30 md/ dl) exhibited a higher prevalence of lipidic plaque at the site of the culprit stenosis (67% vs. 27%; P = 0.02), a wider lipid arc (135 +/- 114 vs 59 +/- 111; P = 0.03) and a higher prevalence of TCFA (38% vs. 10%; P = 0.04).
Lingua originaleEnglish
pagine (da-a)214-220
Numero di pagine7
RivistaAtherosclerosis
Volume246
DOI
Stato di pubblicazionePubblicato - 2016

Keywords

  • Coronary artery disease
  • Lipoprotein(a)
  • Optical coherence tomography
  • plaque morphology

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