Correlation between Serum Lipoprotein(a) Levels and Severity of Coronary Artery Disease in Young Adults Under 45

Authors

DOI:

https://doi.org/10.62497/IRABCS.128

Keywords:

Lipoprotein(a), Coronary Artery Disease, CAD, Young Adult, Gensini Score, Cardiovascular Risk Factors

Abstract

Introduction: The death and disability rates from coronary artery disease (CAD) are substantial even in adults under 45, but traditional risk factors such as hypertension, diabetes mellitus, smoking, and dyslipidemia don’t fully explain its early onset. Genetically programmed lipoprotein(a) is becoming more widely acknowledged as a separate risk factor for early-onset coronary artery disease. This study evaluated the relationship involving serum Lp(a) levels and CAD severity in young adults.

Materials and Methods: A cross-sectional investigation was carried out at the Cardiology Department of Lady Reading Hospital (LRH), Peshawar, over a period of 12 months from January 2023 to December 2023. Included were 98 subjects who had coronary angiography and were less than 45 years old. Serum Lp(a) levels were measured, and CAD severity was assessed using the Gensini score. Statistical analyses including Pearson correlation, chi-square test, independent t-test, ANOVA, and multivariate linear regression were applied using SPSS version 26.

Results: The mean age was 39.2 ± 4.6 years, with 72.4% males and 27.6% females. Elevated Lp(a) levels (>30 mg/dL) were observed in 63.2% of patients. There was a noteworthy positive association between the Gensini score and Lp(a) levels (r = 0.61, p < 0.001). Individuals having severe CAD had significantly more mean Lp(a) levels than those with mild CAD. Multivariate regression analysis confirmed Lp(a) as an independent predictor of CAD severity.

Conclusion: Higher Lp(a) values are closely linked to greater angiographic severity of CAD in young adults. Routine screening in young adults with cardiovascular risk factors may aid in early risk identification and prevention.

Downloads

Download data is not yet available.

Author Biographies

  • Dr. Kiran Bashir, Abbottabad International Medical College, Abbottabad, Pakistan

    MBBS

  • Dr. Habiba Qazi, KMU Institute of Medical Sciences, Kohat, Pakistan

    MBBS

  • Dr. Israr Ul Haq, Gomal Medical College, DI Khan, Pakistan

    MBBS

  • Dr. Syed Rashid Mansoor, Khyber Medical College, Peshawar, Pakistan.

    MBBS

  • Dr. Muhammad Umair, Bacha Khan Medical College, Mardan, Pakistan

    MBBS

References

Jubran A, Zetser A, Zafrir B. Lipoprotein (a) screening in young and middle-aged patients presenting with acute coronary syndrome. Cardiology Journal. 2019;26(5):511-8.

Zhang Y, Vittinghoff E, Pletcher MJ, Allen NB, Zeki Al Hazzouri A, Yaffe K, Balte PP, Alonso A, Newman AB, Ives DG, Rana JS. Associations of blood pressure and cholesterol levels during young adulthood with later cardiovascular events. Journal of the American college of cardiology. 2019 Jul 23;74(3):330-41.

Sun J, Han W, Wu S, Jia S, Yan Z, Guo Y, Zhao Y, Zhou Y, Liu W. Associations between hyperhomocysteinemia and the presence and severity of acute coronary syndrome in young adults≤ 35 years of age. BMC cardiovascular disorders. 2021 Dec;21:1-0.

Gilliland TC, Liu Y, Mohebi R, Miksenas H, Haidermota S, Wong M, Hu X, Cristino JR, Browne A, Plutzky J, Tsimikas S. Lipoprotein (a), oxidized phospholipids, and coronary artery disease severity and outcomes. Journal of the American College of Cardiology. 2023 May 9;81(18):1780-92.

Sun J, Han W, Wu S, Jia S, Yan Z, Guo Y, Zhao Y, Zhou Y, Liu X. Combined effect of hyperhomocysteinemia and smoking on the severity of coronary artery disease in young adults≤ 35 years of age: a hospital-based observational study. BMC Cardiovascular Disorders. 2021 Dec;21:1-9.

Tsimikas S, Karwatowska-Prokopczuk E, Gouni-Berthold I, Tardif JC, Baum SJ, Steinhagen-Thiessen E, Shapiro MD, Stroes ES, Moriarty PM, Nordestgaard BG, Xia S. Lipoprotein (a) reduction in persons with cardiovascular disease. New England Journal of Medicine. 2020 Jan 16;382(3):244-55.

Chung YH, Lee BK, Kwon HM, Min PK, Choi EY, Yoon YW, Hong BK, Rim SJ, Kim JY. Coronary calcification is associated with elevated serum lipoprotein (a) levels in asymptomatic men over the age of 45 years: a cross-sectional study of the Korean national health checkup data. Medicine. 2021 Mar 5;100(9):e24962.

EISSA AH, NAwAwI KN, MOHAMAD MS, ZHIQIN W, HASSAN HH, MASKON O, YAACOB NY, ALI RA. Association between Non Alcoholic Fatty Liver Disease and Severity of Coronary Artery Disease in Patients Aged 45 Years and Below with Acute Coronary Syndrome. Journal of Clinical & Diagnostic Research. 2021 Nov 1;15(11).

Agrawal A, Lamichhane P, Eghbali M, Xavier R, Cook DE, Elsherbiny RM, Jhajj LK, Khanal R. Risk factors, lab parameters, angiographic characteristics and outcomes of coronary artery disease in young South Asian patients: a systematic review. Journal of International Medical Research. 2023 Aug;51(8):03000605231187806.

George J, Kataria SP, Isser HS. The corelation of serum uric acid with risk factors and severity of coronary artery disease (CAD) in acute coronary syndrome. International Journal of Contemporary Medicine Surgery and Radiology. 2019;4(4):D107-12.

Dos Santos CC, Matharoo AS, Cueva EP, Amin U, Ramos AA, Mann NK, Maheen S, Butchireddy J, Falki VB, Itrat A, Rajkumar N. The influence of sex, age, and race on coronary artery disease: a narrative review. Cureus. 2023 Oct 27;15(10).

Wu Z, Cui H, Li W, Zhang Y, Liu L, Liu Z, Zhang W, Zheng T, Yang J. Comparison of three non-insulin-based insulin resistance indexes in predicting the presence and severity of coronary artery disease. Frontiers in cardiovascular medicine. 2022 Jul 29;9:918359.

Hou J, Deng Q, Guo X, Deng X, Zhong W, Zhong Z. Association between apolipoprotein E gene polymorphism and the risk of coronary artery disease in Hakka postmenopausal women in southern China. Lipids in Health and Disease. 2020 Dec;19:1-7.

Huang M, Liu F, Li Z, Liu Y, Su J, Ma M, He Y, Bu H, Gao S, Wang H, Yu C. Relationship between red cell distribution width/albumin ratio and carotid plaque in different glucose metabolic states in patients with coronary heart disease: a RCSCD-TCM study in China. Cardiovascular diabetology. 2023 Feb 22;22(1):39.

Alloubani A, Nimer R, Samara R. Relationship between hyperlipidemia, cardiovascular disease and stroke: a systematic review. Current Cardiology Reviews. 2021 Nov 1;17(6):52-66.

Kosmas CE, Rodriguez Polanco S, Bousvarou MD, Papakonstantinou EJ, Peña Genao E, Guzman E, Kostara CE. The triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio as a risk marker for metabolic syndrome and cardiovascular disease. Diagnostics. 2023 Mar 1;13(5):929.

Lau FD, Giugliano RP. Lipoprotein (a) and its significance in cardiovascular disease: a review. JAMA cardiology. 2022 Jul 1;7(7):760-9.

Shao C, Wang J, Tian J, Tang YD. Coronary artery disease: from mechanism to clinical practice. Coronary Artery Disease: Therapeutics and Drug Discovery. 2020:1-36.

Published

06/30/2025

Issue

Section

Research Articles

Categories

How to Cite

1.
Bashir K, Qazi H, Haq IU, Mansoor SR, Umair M. Correlation between Serum Lipoprotein(a) Levels and Severity of Coronary Artery Disease in Young Adults Under 45. IRABCS [Internet]. 2025 Jun. 30 [cited 2025 Jul. 13];3(1). Available from: https://irjpl.org/irabcs/article/view/128