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Association of lipoprotein(a) and coronary artery disease in 1003 patients with stage 3–5 chronic kidney disease undergoing coronary angiography

Lin, Li-Huab; Liu, Honga,b; Tu, Yana; Yang, Yana; Wang, Bina,b; Wang, Feng-Meia; Wu, Mina; Pan, Ming-minga,b; Tang, Ri-Ninga,b; Ma, Kun-Linga,b; Zhang, Xiao-Lianga,b; Liu, Bi-Chenga,b

doi: 10.1097/MCA.0000000000000692
Lipids in CAD

Aim Lipoprotein(a) [Lp(a)] is considered a risk factor for cardiovascular disease. However, the role of Lp(a) in chronic kidney disease (CKD) patients is not well understood. The aim of this study was to evaluate the association between Lp(a) levels and the presence of coronary artery disease (CAD) and the severity of coronary artery stenosis (CAS) in patients with stage 3–5 CKD.

Patients and methods We retrospectively studied patients who were diagnosed with stage 3–5 CKD and underwent coronary artery angiography in Zhongda Hospital. The Gensini scoring system was used to assess the severity of coronary stenosis.

Results A total of 1003 patients were enrolled in this cross-sectional study, and 776 of these patients were diagnosed with CAD. The Lp(a) levels were significantly higher in the CAD group than the non-CAD group [271.50 (168.00–459.25) vs. 195.00 (131.00–347.00) mg/l, P<0.001]. Multivariate logistic regression analysis showed that the Lp(a) tertiles were associated independently with the presence of CAD [tertile 2 vs. tertile 1 [adjusted odds ratio (OR)=2.063, 95% confidence interval (CI): 1.394–3.053, P<0.001] and tertile 3 vs. tertile 1 (adjusted OR=2.022, 95% CI: 1.345–3.040, P=0.001)]. After adjusting for potential confounders, the Lp(a) levels were associated independently with severe CAS [tertile 2 vs. tertile 1 (adjusted OR=1.603, 95% CI: 1.040–2.472, P=0.033); tertile 3 vs. tertile 1 (adjusted OR=1.743, 95% CI: 1.128–2.693, P=0.012)].

Conclusion Higher Lp(a) levels were associated the presence of CAD and the severe CAS among patients with stage 3–5 CKD independently.

aDepartment of Nephrology, Nephrology Division, Zhongda Hospital

bDepartment of Nephrology, School of Medicine, Southeast University, Nanjing, Jiangsu, China

Correspondence to Hong Liu, MD, PhD, Nanjing, 210009 Jiangsu Province, China Tel: +86 258 326 2423; fax: +86 258 326 2423; e-mail:

Received September 27, 2018

Received in revised form December 4, 2018

Accepted December 8, 2018

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