Objective To investigate the factors influencing the incidence and severity of coronary heart disease(CHD)with moderately elevated lipoprotein(a)[Lp(a)].Methods A retrospective study included 484 patients with moderately elevated Lp(a)(ranging from 550～650 mg/L)underwent coronary angiography in Zhongshan Hospital of Fudan University from January 2017 to July 2019.According to the results of coronary angiography,patients were divided into a CHD group(n=298)and a non-CHD group(n=186),and the clinical data of the two groups were compared.Univariate and multivariate logistic regression were used to analyze the influencing factors of CHD in patients with Lp(a)elevation.Gensini score was used to evaluate the severity of CHD in patients with CHD,and ordered univariate and multivariate logistic regression was used to analyze the influencing factors of the severity of CHD in patients with increased Lp(a).Results The proportion of male,age,hypertension,hyperlipidemia,diabetes,smoking,erythrocyte,hemoglobin,neutrophil,neutrophil/lymphocyte ratio,triglyceride,glycated hemoglobin and fasting blood glucose in CHD group were significantly higher than those in non-CHD group(all P＜0.05).However,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol and apolipoprotein(Apo)E were significantly lower than those in the non-CHD group(all P＜0.05).Gender(OR=0.338),age(OR=1.041),hypertension(OR=1.817),hyperlipidemia(OR=2.288),neutrophil to lymphocyte ratio(OR=1.231),ApoE(OR=0.972)and glycosylated hemoglobin(OR=0.187)were independent risk factors for coronary heart disease in patients with elevated Lp(a)(all P＜0.05).There were 100 patients with high Gensini score,100 patients with medium Gensini score,and 98 patients with low Gensini score.Hypertension(OR=0.573)and ApoA1(OR=3.209)were independent risk factors for the severity of CHD(both P＜0.05).Conclusion Gender,age,hypertension,dyslipidemia,neutrophil-to-lymphocyte ratio,ApoE,and glycated hemoglobin are all independent influencing factors for the incidence of CHD in patients with moderately elevated Lp(a),while hypertension and ApoA1 are independent risk factors for the severity of CHD.
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