Abstract
Elevated lipoprotein(a) [Lp(a)] is a risk factor for coronary heart disease (CHD), but there are few studies on the prediction of future cardiovascular events by Lp(a) and its LPA single nucleotide polymorphisms (SNPs). The aim of this study was to investigate whether elevated Lp(a) and its SNPs can predict cardiovascular events. We evaluated whether Lp(a) and LPA SNPs rs6415084 and rs12194138 were associated with the incidence rate and severity of CHD. All participants were followed up for 5 years. Elevated Lp(a) is an independent risk factor for the risk and severity of CHD (CHD group vs. control group: OR = 1.793, 95% CI: 1.053–2.882, p = 0.043; multiple-vessel disease group vs. single-vessel disease group: OR = 1.941, 95% CI: 1.113–3.242, p = 0.027; high GS group vs. low GS group: OR = 2.641, 95% CI: 1.102–7.436, p = 0.040). Both LPA SNPs were risk factors for CHD, and were positively associated with the severity of CHD (LPA SNPs rs6415084: CHD group vs. control group: OR = 1.577, 95% CI: 1.105–1.989, p = 0.004; multiple-vessel disease group vs. single-vessel disease group: OR = 1.613, 95% CI: 1.076–2.641, p = 0.030; high GS group vs. low GS group: OR = 1.580, 95% CI: 1.088–2.429, p = 0.024; LPA SNPs rs12194138: CHD group vs. control group: OR = 1.475, 95% CI: 1.040–3.002, p = 0.035; multiple-vessel disease group vs. single-vessel disease group: OR = 2.274, 95% CI: 1.060–5.148, p = 0.038; high GS group vs. low GS group: OR = 2.067, 95% CI: 1.101–4.647, p = 0.021). After 5 years of follow-up, elevated Lp(a) and LPA SNPs rs6415084 and rs12194138 can independently predict cardiovascular events. The increase of serum Lp(a) and LPA SNPs rs6415084 and rs12194138 are associated with increased prevalence and severity of CHD, and can independently predict cardiovascular events.
Highlights
Cardiovascular disease has the highest incidence rate and mortality rate in the world[1–4]
Major cardiovascular events (MACEs) are divided into cardiovascular mortality, non-fatal myocardial infarction (MI), non-fatal stroke, heart failure, hospitalized unstable angina and non-coronary heart disease patients diagnosed as coronary heart disease
The multiple logistic regression analysis adjusted for age, sex, body mass index (BMI), diabetes, hypertension, smoking, consumers of alcohol, fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), ApoB, ApoA1, total cholesterol (TC), TG, high density lipoprotein cholesterol (HDL-C), hypersensitive C-reactive protein (hs-CRP), and HCY, the level of Lp(a) remained to be independently associated with the presence and severity of coronary heart disease (CHD) (CHD group vs. control group: OR = 1.793, 95% CI: 1.053–2.882, p = 0.043; multiple-vessel disease group vs. single-vessel disease group: OR = 1.941, 95% CI: 1.113–3.242, p = 0.027; high Gensini score (GS) group vs. low GS group: OR = 2.641, 95% CI: 1.102–7.436, p = 0.040)
Summary
Cardiovascular disease has the highest incidence rate and mortality rate in the world[1–4]. Large epidemiological and genetic studies have provided strong evidences that lipoprotein(a) [Lp(a)] is a causal risk factor for coronary heart disease (CHD)[9–11]. Lp(a) is a lipoprotein synthesized from the liver It is an LDL-like particle that consists of an apolipoprotein(a) moiety linked to one molecule of apolipoprotein B100 via a disulfide b ond[12]. Many single nucleotide polymorphisms (SNPs) have been found in LPA17,18, such as rs6415084 and rs12194138, were closely associated with Lp(a) levels. The relationship between Lp(a) levels and SNPs and the risk and severity of CHD as well as future recurrent cardiac events have been less studied, but so far they seem to be weak. Lp(a) and two LPA SNPs are associated with the occurrence and severity of CHD and long-term cardiovascular events
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