Correlation of lipoprotein (a) to angiographically defined coronary artery disease in Indians

Lipoprotein (a) [Lp(a)] levels have been correlated with angiographically defined coronary artery disease (CAD). Pattern of Lp(a) distribution in various racial groups is different. To study this relationship in Indian patients, plasma levels of Lp(a) and other lipid values were assessed in 101 patients undergoing coronary arteriography. Lp(a) concentration was higher in CAD group (n = 77) compared to normal coronary artery group (n = 24) (26.83 ± 22.09 mg/dl vs. 15.07 ± 14.61 mg/dl, P < 0.05). Lp(a) values had graded association with CAD. In Lp(a) quartile of < 5 mg/dl, 66.7%. patients had CAD; in Lp(a) quartile of 5–25 mg/dl, 69.0% had CAD; in Lp(a) quartile of 26–75 mg/dl, 87.5% had CAD; and in Lp(a) quartile of ≥ 76 mg/dl, all patients had CAD. High density lipoprotein (HDL) cholesterol was higher in the normal coronary artery group as compared to CAD group (45.25±8.26 mg/dl vs. 41.83±16.47 mg/dl; NS). In HDL quartile of <35 mg/dl, 88.9% patients had angiographically defined CAD. Plasma values of total cholesterol, triglycerides (TG), apolipoprotein-A1 (Apo-A1), apolipoprotein-B (Apo-B), low density lipoprotein (LDL) cholesterol, image cholesterol ratio and Apo image ratio were not significantly different in the groups with normal coronary arteries and CAD. Our results indicate that the measurement of Lp(a) provides a better marker for predicting the presence of angiographically defined CAD as compared to traditional measures.