Abstract

Background: Elevated lipoprotein (a) [Lp(a)] levels are an emerging risk factor for premature atherosclerotic cardiovascular disease. This study examined the relationship between Lp(a) and angiographic coronary disease burden in young patients with acute coronary syndrome (ACS). Methods: This cross-sectional observational study included 50 patients aged ≤40 years admitted with ACS at a tertiary care centre between June 2023 and December 2023. Patients with previous coronary revascularization, chronic kidney disease, liver disease or other severe comorbidities were excluded. Demographic data, clinical details and Lp(a) levels were collected. The extent and severity of coronary artery disease (CAD) were assessed using the Gensini score during coronary angiography. The correlation between Lp(a) levels and Gensini score was analyzed. Results: The mean age of patients was 35.7 ± 4.0 years and 80% were males. The mean Lp(a) level was 32.4 ± 28.1 mg/dL. Most patients had single-vessel (56.7%) or double-vessel disease (23.3%). There was a significant positive correlation between Lp(a) levels and Gensini score (p<0.001). Patients with triple-vessel disease had significantly higher mean Lp(a) levels (82.75 ± 10.1 mg/dL) compared to those with double-vessel (41.29 ± 26.7 mg/dL) or single-vessel disease (19.76 ± 15.3 mg/dL). The patients with Lp(a) <10 has more incidence of recanalised CAD. Conclusion: In young ACS patients, elevated Lp(a) levels showed a strong positive correlation with angiographic severity of CAD, as assessed by the Gensini score. Higher Lp(a) levels were associated with more extensive coronary atherosclerosis, underscoring its role as an inherited risk factor for premature cardiovascular disease.

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