Evaluation of diagnostic value of lipoprotein(a), serum lipids and their combination in coronary heart disease

Objective To evaluate the diagnostic value of lipoprotein(a), serum lipids and their combination in coronary heart disease(CHD). Methods 638 patients with suspected CHD were enrolled into this study, who were divided into two groups according to the result of coronary arterography: ①CHD group(n=410) and ② non-CHD group(n=228). Their clinical data were analysed by case-control method, and serum lipids were detected by standard method.Results The levels of serum total cholesterol[( 5.0± 1.2) mmol/L], low density lipoprotein cholesterol[( 3.0± 1.0) mmol/L], lipoprotein(a)[(260±226) mg/L] and the ratio of total cholesterol to high density lipoprotein cholesterol( 5.2± 2.0) in CHD group significantly raised (P≤ 0.001), compared with non-CHD group[( 4.6± 1.1) mmol/L,( 2.6± 0.9) mmol/L,(192±174) mg/L, 4.5± 1.5], whereas the level of high density lipoprotein cholesterol[( 1.0± 0.3) mmol/L] of the former group was significantly lower than that of the latter group [( 1.1± 0.3) mmol/L] (P= 0.045). There was not significant difference in serum triglyceride level and triglyceride/high density lipoprotein cholesterol ratio between two groups. The abnormal rate of total cholesterol, low density lipoprotein cholesterol, lipoprotein(a) and total cholesterol/ high density lipoprotein cholesterol ratio in CHD group significantly increased, while the abnormal rate of other lipids did not significantly differ. The predicative value and likelihood ratio of lipoprotein(a) for CHD was not superior to that of other lipids, but when combined with low density lipoprotein cholesterol, the value would further be elevated. In logistic regression model, lipoprotein(a) was not more related to CHD risk than other lipids.Conclusion The diagnostic value of lipoprotein(a) is not better than other lipids, when combined with low density lipoprotein cholesterol, it may be regarded as a better predicative marker for CHD.