Novel lipid biomarkers and ratios as risk predictors for premature coronary artery disease: A retrospective analysis of 2952 patients.

Abstract

This study examined the associations between emerging lipid biomarkers (small dense low-density lipoprotein cholesterol [sdLDL-C), lipoprotein(a) [Lp(a)], and free fatty acids [FFA]), two ratios (sdLDL-C/LDL-C and the triglyceride-glucose [TyG) index), and the Gensini score (GS) in patients with premature coronary artery disease (PCAD) in relation to the extent of coronary stenosis. The authors evaluated a cohort of 2952 individuals undergoing coronary angiography (CAG), encompassing those with PCAD (n=1749), late-onset coronary artery disease (LCAD; n=328), and non-coronary artery disease (non-CAD; n=575). Noteworthy differences were observed in the levels of the novel lipid biomarkers and ratio indexes among the PCAD, LCAD, and non-CAD groups (p<.05). Multiple logistic regression analyses pinpointed Lp(a) (OR=2.62, 95% CI 1.22-5.63, p=.014) and the TyG index (OR=2.53, 95% CI 1.08-5.93, p=.033) as independent risk factors for PCAD. Furthermore, these biomarkers and ratio indexes discerned substantial distinctions among PCAD patients with varying GS (p<.05). Consequently, these markers can proficiently anticipate the gravity of coronary artery stenosis (GS>40) in PCAD patients, as evidenced by the ROC analysis. In conclusion, sdLDL-C, Lp(a), FFA, and the sdLDL-C/LDL-C and TyG indexeshave considerable potential as risk and diagnostic markers for coronary artery stenosis in individuals afflicted with PCAD.