Serum Lipoprotein (a) as a Diagnostic Marker of Coronary Artery Disease: A Case-Control Study

Abstract

Introduction: Coronary Artery Disease (CAD) is a major cause of mortality in India. Conventional risk factors fail to explain the increasing burden of CAD, thus necessitating to search for newer risk factors like Lipoprotein (a) {Lp(a)}. Lp(a) is considered as one of the risk marker of CAD. Lp(a) levels have shown wide ethnic variation among human population. Aim: The study was aimed to estimate Lp(a) levels in CAD patients and to compare it with healthy controls. To see the correlation between Lp (a) with other lipid parameters and also to find the best cut-off value for Lp(a) in CAD patients in North Karnataka population. Materials and Methods: This was hospital based, observational, case-control study done on 120 participants, with 60 CAD patients and 60 healthy controls. Lipid profile, Lp(a) and FBS (Fasting Blood Sugar) was analysed along with anthropometric measurements. Quantitative data expressed as mean±SD. Student's t-test for comparison, Pearson correlation for correlation and Receiver Operating Curve (ROC) to get the best cut-off value for Lp(a) was used. Results: Lp(a) levels were significantly increased (p0.8 with 78% sensitivity and 86% specificity. The best cut-off value is 23.7 mg/dL. Lp(a) positively correlated with Total Cholesterol (TC), Low Density Lipoprotein cholesterol (LDL) and negatively correlated with HDL. Conclusion: Raised Lp(a) levels is associated with an increased risk and may serve as marker of CAD. When Lp(a) is above 23.7 mg/dL. it acts as a predictor for CAD even when lipid levels are in normal range. It is better to assess the Lp(a) along with routine lipid profile in all patients with CAD in north Karnataka.

Keywords

• dyslipidemia
• low density lipoprotein variant
• risk factor