Abstract TP226: Analysis of the Association Between Lipoprotein(a) Levels and Carotid Plaque and Coronary Artery Calcium Using Health Checkup Data

Abstract

Background: Lipoprotein a (Lp(a)) is known to be associated with coronary artery disease and carotid artery atherosclerosis. We analyzed the association between Lp(a) levels, coronary artery calcium score (CACS), and carotid plaque using data from individuals undergoing health check-ups. Methods: We enrolled patients who underwent all Lp(a) measurements, coronary artery calcium score computed tomography(CT), and carotid ultrasound at Gangnam Severance Hospital from January 2017 to December 2022. Lp(a) levels were categorized into two groups: below 50 mg/dl and 50 mg/dl or higher. Carotid ultrasound results were divided into two groups based on the presence or absence of plaque. Coronary artery calcium score CT results were analyzed in two groups: CACS=0 and CACS>0. Results: A total of 2620 subjects were enrolled. 1692 (64.6%) were male. Mean age was 57 years. Lp(a) levels of 50 or higher were found in 177 (6.8%) subjects. Carotid plaque was observed in 1140 (43.5%) subjects and CACS>0 in 1172 (44.7%) subjects. Multivariable logistic regression analysis was performed. There was an association between Lp(a) 50mg/dl or higher and carotid plaque (unadjusted odds ratio = 1.406, confidence interval = 1.036 - 1.908) (adjusted odds ratio = 1.383, confidence interval = 1.010 - 1.894). An association was also found between Lp(a) 50mg/dl or higher and CACS>0 (unadjusted odds ratio = 1.400, confidence interval = 1.031 - 1.900) (adjusted odds ratio = 1.378, confidence interval = 1.002 - 1.895). Carotid plaque and CACS>0 were associated (unadjusted odds ratio = 4.393, confidence interval = 3.725 - 5.182) (adjusted odds ratio = 2.380, confidence interval = 1.970 - 2.876). Conclusions: This study demonstrates that individuals with Lp(a) levels of 50 mg/dl or higher are at increased risk for carotid plaque and CACS. This association remains independent even after adjustment for factors such as statin use or low-density lipoprotein cholesterol (LDL-C) levels. Therefore, increased attention to the occurrence and progression of coronary artery disease and carotid artery atherosclerosis is necessary in individuals with Lp(a) levels of 50 mg/dl or higher, even if LDL-C levels are well controlled.