The relationship between the level of Lр(а) and the prevalence of atherosclerosis among young patients
- Authors: Klesareva E.A.1, Afanasieva O.I.1, Sherstyuk E.E.1, Tmoyan N.A.1, Razova O.A.1, Tyurina A.V.1, Afanasieva M.I.1, Ezhov M.V.1, Pokrovsky S.N.1
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Affiliations:
- Chazov National Medical Research Center of Cardiology
- Issue: Vol 94, No 4 (2022)
- Pages: 479-484
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/48346
- DOI: https://doi.org/10.26442/00403660.2022.04.201454
- ID: 48346
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Abstract
Background. Hyperlipoproteinemia (a) is an independent and cause risk factor for atherosclerotic cardiovascular diseases (ASCVD). The correlation between lipoprotein (a) – Lp(a) and inflammation in the vessel wall was actively studied during the past few years. C-reactive protein (CRP) plays an important role in ASCVD.
Aim. To analyze the relationship between hyperlipoproteinemia (a), inflammatory markers, and the early development of stenosing atherosclerosis (AS) in several vascular pools.
Materials and methods. 76 patients, 55 men aged 18 to 55 years and 21women – 18 to 60 years, with the results of instrumental examination of coronary, carotid and lower extremities vascular pools were enrolled. Three groups: with stenosing (≥50%) AS of only one (group 1, n=29); two or three (group 2, n=21) vascular pools. 26 patients without coronary heart disease and AS were included in the control group. All patients in groups 1 and 2 and 65% of those in the control group took statins. The concentrations of Lp(a), CRP, lipids and blood count were determined.
Results. The patients of the three groups did not differ in age. In the groups with AS (79% in group 1 and 85% in group 2), there were more men (relative to 54% in the control group). Diabetes mellitus was more common only in patients with multifocal AS. The absolute number of blood monocytes and leukocytes, the neutrophil-lymphocyte ratio, as well as Lp(a) level were higher in patients of groups 1 and 2 relative to the control. The maximum Lp(a) level (median [25%; 75%]) was observed in patients with lesions of two or more vascular pools vs the control group (49 [4; 96] mg/dL, vs 10 [4; 21] mg/dL, p=0.02). The CRP level was significant elevated in patients from group 2 – 7.2 [4.0; 9.7] mg/L, relative to group 1 – 2.5 [1.0; 4.7] mg/L, and the control group 2.9 [1.2; 4.9] mg/L, p<0.05. The Lp(a) and CRP concentration, or the presence of diabetes mellitus in patients, regardless of other risk factors, were associated with severe stenosing AS in young and middle age.
Conclusion. An elevated concentration of Lp(a) (≥30 mg/dL) determines the presence of both isolated and multifocal stenosing AS in the examined patients. A simultaneous increase in the concentration of both Lp(a) and CRP, as well as the presence of diabetes mellitus, are associated with the premature development of stenosing atherosclerotic lesions in several vascular regions at once. Measurement of these predictors in young and middle-aged patients makes it possible to use them as biochemical markers to assess the likelihood of multifocal lesions of the vascular pool.
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##article.viewOnOriginalSite##About the authors
Elena A. Klesareva
Chazov National Medical Research Center of Cardiology
Author for correspondence.
Email: hea@mail.ru
ORCID iD: 0000-0002-0682-8699
Сandidate of technical Sciences, researcher at the laboratory of atherosclerosis problems of the research Institute of experimental cardiology
Russian Federation, MoscowOlga I. Afanasieva
Chazov National Medical Research Center of Cardiology
Email: Afanasieva.cardio@yandex.ru
ORCID iD: 0000-0001-8909-8662
д-р биол. наук, вед. науч. сотр. лаб. проблем атеросклероза Института экспериментальной кардиологии
Russian Federation, MoscowEkaterina E. Sherstyuk
Chazov National Medical Research Center of Cardiology
Email: katyushiksher@mail.ru
ORCID iD: 0000-0002-8012-3339
лаборант-исследователь лаб. проблем атеросклероза Института экспериментальной кардиологии
Russian Federation, MoscowNarek A. Tmoyan
Chazov National Medical Research Center of Cardiology
Email: ntmoyan@gmail.com
ORCID iD: 0000-0002-3617-9343
канд. мед. наук, науч. сотр. лаб. нарушений липидного обмена Института клинической кардиологии им. А.Л. Мясникова
Russian Federation, MoscowOksana A. Razova
Chazov National Medical Research Center of Cardiology
Email: oarazova@yandex.ru
ORCID iD: 0000-0002-1132-2529
науч. сотр. лаб. проблем атеросклероза Института экспериментальной кардиологии
Russian Federation, MoscowAleksandra V. Tyurina
Chazov National Medical Research Center of Cardiology
Email: alex.tyurina.cardio@yandex.ru
ORCID iD: 0000-0003-3505-2487
аспирант отд. проблем атеросклероза Института клинической кардиологии им. А.Л. Мясникова
Russian Federation, MoscowMarina I. Afanasieva
Chazov National Medical Research Center of Cardiology
Email: afanasievabiocomerts@yandex.ru
ORCID iD: 0000-0002-5725-3805
науч. сотр. лаб. проблем атеросклероза Института экспериментальной кардиологии
Russian Federation, MoscowMarat V. Ezhov
Chazov National Medical Research Center of Cardiology
Email: marat_ezhov@mail.ru
ORCID iD: 0000-0002-1518-6552
д-р мед. наук, гл. науч. сотр., и. о. рук. лаб. нарушений липидного обмена Института клинической кардиологии им. А.Л. Мясникова
Russian Federation, MoscowSergei N. Pokrovsky
Chazov National Medical Research Center of Cardiology
Email: dr.pokrovsky@mail.ru
ORCID iD: 0000-0001-5944-6427
д-р биол. наук, проф., гл. науч. сотр., и. о. рук. лаб. проблем атеросклероза Института экспериментальной кардиологии
Russian Federation, MoscowReferences
- Herrington W, Lacey B, Sherliker P, et al. Epidemiology of Atherosclerosis and the Potential to Reduce the Global Burden of Atherothrombotic Disease. Circ Res. 2016;118(4):535-46. doi: 10.1161/circresaha.115.307611
- Berard AM, Bedel A, Le Trequesser R, et al. Novel Risk Factors for Premature Peripheral Arterial Occlusive Disease in Non-Diabetic Patients: A Case-Control Study. Plos One. 2013;8(3). doi: 10.1371/journal.pone.0037882
- Avan A, Sany SBT, Ghayour-Mobarhan M, et al. Serum C-reactive protein in the prediction of cardiovascular diseases: Overview of the latest clinical studies and public health practice. J Cell Physiol. 2018;233(11):8508-25. doi: 10.1002/jcp.26791
- Ridker P. A Test in Context High-Sensitivity C-Reactive Protein. J Am Coll Cardiol. 2016;67(6):712. doi: 10.1016/j.jacc.2015.11.037
- Van Wijk DF, Boekholdt SM, Wareham NJ, et al. C-Reactive Protein, Fatal and Nonfatal Coronary Artery Disease, Stroke, and Peripheral Artery Disease in the Prospective EPIC-Norfolk Cohort Study. Arterioscler Thromb Vasc Biol. 2013;33(12):2888-94. doi: 10.1161/atvbaha.113.301736
- Kalay N, Dogdu O, Koc F, et al. Hematologic Parameters and Angiographic Progression of Coronary Atherosclerosis. Angiology. 2012;63(3):213-7. doi: 10.1177/0003319711412763
- Nordestgaard BG, Langsted A. Lipoprotein (a) as a cause of cardiovascular disease: insights from epidemiology, genetics, and biology. J Lipid Res. 2016;57(11):1953-75. doi: 10.1194/jlr.R071233
- Dahlen GH. Incidence of Lp(a) among populations. Lipoprotein (a). Ed. AM Scanu. New York: Academic Press, 1990; p. 151-73.
- Афанасьева О.И., Адамова И.Ю., Беневоленская Г.Ф., Покровский С.Н. Иммуноферментный метод определения липопротеида (а). Бюллетень экспериментальной биологии и медицины. 1995;120(10):398-401 [Afanasieva OI, Adamova IYu, Benevolenskaya GF, Pokrovsky SN. An immunoenzyme method for determining lipoprotein (a). Biulleten' eksperimental'noi biologii i meditsiny. 1995;120(10):398-401 (in Russian)]. doi: 10.1007/bf02444976
- Libby P, Loscalzo J, Ridker PM, et al. Inflammation, Immunity, and Infection in Atherothrombosis JACC Review Topic of the Week. J Am Coll Cardiol. 2018;72(17):2071-81. doi: 10.1016/j.jacc.2018.08.1043
- Афанасьева О.И., Тмоян Н.А., Клесарева Е.А., и др. Взаимосвязь концентрации липопротеида (а) и показателей воспаления с мультифокальным атеросклерозом у женщин. Кардиология. 2019;59(10):39-48 [Afanasieva OI, Tmoyan NA, Klesareva EA, et al. The relationship of the concentration of lipoprotein (a) and markers of inflammation with multifocal atherosclerosis in women. Kardiologiya. 2019;59(10):39-48 (in Russian)]. doi: 10.18087/cardio.2019.10.n520
- Gurdasani D, Sjouke B, Tsimikas S, et al. Lipoprotein (a) and Risk of Coronary, Cerebrovascular, and Peripheral Artery Disease The EPIC-Norfolk Prospective Population Study. Arterioscler Thromb Vasc Biol. 2012;32(12):3058-65. doi: 10.1161/atvbaha.112.255521
- Cicek H, Bayil S, Zer Y, et al. Comparison of lipoprotein (a) levels between elderly and middle-aged men with coronary artery disease. Ann N Y Acad Sci. 2007;1100:179-84. doi: 10.1196/annals.1395.016
- Ежов М.В., Афанасьева О.И., Камбегова А.А., и др. Роль факторов риска атеросклероза в развитии ишемической болезни у мужчин молодого возраста. Терапевтический архив. 2009;81(5):50-3 [Ezhov MV, Afanasyeva OI, Kambegova AA, et al. The role of atherosclerosis risk factors in development of coronary artery disease in young men. Terapevticheskii Arkhiv (Ter. Arkh.). 2009;81(5):50-4 (in Russian)].
- Danik JS, Rifai N, Buring JE, Ridker PM. Lipoprotein (a), measured with an assay independent of apolipoprotein (a) isoform size, and risk of future cardiovascular events among initially healthy women. JAMA. 2006;296(11):1363-70. doi: 10.1001/jama.296.11.1363
- Borrelli MJ, Youssef A, Boffa MB, Koschinsky M. New Frontiers in Lp(a)-Targeted Therapies. Trends Pharmacol Sci. 2019;40(3):212-25. doi: 10.1016/j.tips.2019.01.004
- Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111-88. doi: 10.1093/eurheartj/ehz455
- Shai I, Rimm EB, Hankinson SE, et al. Lipoprotein (a) and coronary heart disease among women: beyond a cholesterol carrier? Eur Heart J. 2005;26(16):1633-9. doi: 10.1093/eurheartj/ehi222
- Varastehravan H, Naghedi A, Razavi-Ratki SK, et al. Correlation between neutrophil to lymphocyte ratio and coronary calcium score in CT angiography. NLR and coronary calcification. Medicina Balear. 2020;35(2):41-6. doi: 10.3306/medicinabalear.35.02.41
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