Lipoprotein(a) and LDL particle size are related to the severity of coronary artery disease.
BACKGROUND
The pathophysiological role and metabolic pathway of Lp(a) have not been clearly defined. An association between Lp(a) and oxidative low-density lipoprotein (LDL) were recently reported. And small dense LDL (sd-LDL) were associated with circulating malondialdehyde-modified LDL. We investigated the relationships between serum Lp(a) level and LDL particle size in coronary artery disease (CAD) patients. Further, we investigated the relationships of sd-LDL and Lp(a) with the extent and severity of CAD.


METHODS
A total of 490 patients (mean: 60.5 +/- 11.5 years old) who underwent coronary angiography to evaluate chest pain were investigated. Patients were classified into two groups, a CAD group (n = 256), who had significant stenosis observed by coronary angiogram, and a control group (n = 234), who had normal, or minimal coronary arteries. CAD severity was measured by Gensini scores. The distribution of the LDL subfraction was analyzed using a Quantimetrix Lipoprint LDL System.


RESULTS
The serum Lp(a) concentration was correlated with the fraction of sd-LDL (r = 0.193, p < 0.001) and mean LDL size (r = 0.160, p = 0.003). The Lp(a) level and mean LDL particle size were significantly correlated with a high Gensini score. LDL particle size in the CAD group was smaller than in the control group (26.74 +/- 0.64 vs. 26.43 +/- 0.93 nm, p < 0.001). The Gensini score was significantly higher in small LDL with high Lp(a) level groups.


CONCLUSIONS
The positive correlation of the level of Lp(a) and sd-LDL fraction were demonstrated. The mechanism of this association is not clearly defined; we can suggest that it may stem from the individual atherogenic condition that linked to increased oxidative stress. Both increased Lp(a) and sd-LDL fraction were correlated with the severity of CAD.
Moon
Jae-Youn
JY
Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Kwon
Hyuck Moon
HM
Kwon
Sung Woo
SW
Yoon
Se-Jung
SJ
Kim
Jung-Sun
JS
Lee
Sung-Ju
SJ
Park
Jong Kwan
JK
Rhee
Ji-Hyuck
JH
Yoon
Young Won
YW
Hong
Bum-Kee
BK
Rim
Se-Joong
SJ
Kim
Hyun Seung
HS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000000981:diagnostic imaging*; D008078:Cholesterol, LDL / Q000097:blood*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D023921:Coronary Stenosis / Q000097:blood / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010316:Particle Size
D008078:Cholesterol, LDL; D017270:Lipoprotein(a)