Objective To investigate the correlation between lipoprotein(a)[Lp(a)]and coronary stenosis in acute coronary syndrome(ACS)patients with different C-reactive protein(CRP)levels.Methods A total of 429 patients with acute coronary syndrome were enrolled in the study.Serum CRP and Lp(a)levels were measured with high sensitivity turbidimetry and enzyme-linked immunosorbent assay,respectively.CRP≥10 mg/L was defined as CRP+,and CRP＜10 mg/L was defined as CRP-;Lp(a)≥300 ng/mL is defined as Lp(a)+,and Lp(a)＜300 ng/mL is defined as Lp(a)-.Based on CRP and Lp(a)levels patients were divided into four groups:CRP-/Lp(a)-,CRP-/Lp(a)+,CRP+/Lp(a)-,CRP+/Lp(a)+.The severity of coronary artery stenosis was evaluated by coronary angiography and calculated as the Gensini score.Multivariate logistic regression model was applied to analyze the relationship of CRP and Lp(a)levels with the degree of coronary artery stenosis.Results There were significant differences in age,smoking,hypertension,diabetes,and Gensini score among the four groups(P＜0.05).Multivariate regression analysis showed that for patients with CRP-,the age,smoking,and diabetes were independent risk factors for Gensini score(P＜0.05);while for patients with CRP+,the age,smoking,diabetes and LP(a)+were independent risk factors of Gensini score(P＜0.05).Patients with CRP-/Lp(a)-had the lowest correlation with coronary artery stenosis(95％CI:0.111-8.520),while those with CRP+/Lp(a)+had the highest correlation with coronary artery stenosis(95％CI:4.674-21.230).Conclusion The CRP+/Lp(a)+is more close with the degree of coronary artery stenosis,therefore,reducing serum Lp(a)level may bring more benefit in patients with high levels of inflammation.
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