Correlation of lipoprotein (a) levels and plaque morphology in very young acute coronary syndrome patients using optical coherence tomography
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Date
2022-10
Journal Title
Journal ISSN
Volume Title
Publisher
Cardiological Society of India
Abstract
Introduction: Levels of lipoprotein (LP) (a) are useful marker for risk stratification of cardiovascular disease. This genetic biomarker is suggestive of patient predisposition to acute coronary event. The present study was to study correlation of LP(a) levels and plaque morphology in very young patients (<35 years) with acute coronary syndrome (ACS). Methods: A prospective, single-center, observational study consisting of very young patients with ACS and fit for optical coherence tomography (OCT) guided invasive coronary angiography was conducted at tertiary-care centre. LP(a) levels were compared between healthy controls and very young ACS patients. Correlation of LP(a) levels and plaque characteristics in very young ACS patients was done using OCT imaging. Results: Out of enrolled 80 subjects, 40 were very young ACS and 40 were matched healthy controls. In very young patients, plaque rupture and erosion were mechanism of ACS in 67.5% and 32.5% patients, respectively. Mean levels of LP(a) were 28.10 ± 13.96 nmol/l in healthy controls and 47.19 ± 29.85 nmol/l in very young patients with ACS (p ¼ 0.022). Among very young ACS patients, patients with LP(a) levels<75 nmol/l and 75 nmol/l had mean thin cap fibroatheroma thickness of 117.08 ± 52.542 mm and 95.00 ± 36.286 mm, respectively (p ¼ 0.2355). Conclusion: Higher levels of LP(a) were seen in younger patients with ACS compared with matched healthy individuals. Plaque rupture was the commonest mechanism of ACS in very young ACS patients. Patients with high LP(a) levels had lesser thickness of fibrous cap in OCT imaging compared with low levels of LP(a).
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Keywords
Acute coronary syndrome, Coronary artery disease, Lipoprotein (a), Optical coherence tomography, Plaque
Citation
Chandra Sharad, Nagar Saurabh, Shukla Ayush, Chaudhary Gaurav, Sharma Akhil, Pradhan Akshyaya, Bhandari Monika, Vishwakarma Pravesh, Sethi Rishi, Narain Varun Shankar, Dwivedi Sudhanshu Kumar. Correlation of lipoprotein (a) levels and plaque morphology in very young acute coronary syndrome patients using optical coherence tomography. Indian Heart Journal. 2022 Oct; 74(5): 357-362