Epidemiology
Higher Lp(a) tracks with more severe coronary disease by SYNTAX score in a 51-patient South Asian angiography cohort (Cardiovasc Endocrinol Metab 2025)
Original title: Cross-sectional study of lipoprotein(a) and the severity of coronary artery disease, cerebrovascular disease, and peripheral vascular disease in a group of South Asian patients
This cross-sectional study reviewed 60 consecutive South Asian patients undergoing coronary angiography, of whom 51 were eligible for evaluation of Lp(a) level alongside SYNTAX score for coronary disease severity, carotid ultrasound/Doppler for cerebrovascular disease, and ankle-brachial index for peripheral vascular disease, using the multisite arterial disease score 2 (MADS2) framework. Higher Lp(a) levels were significantly associated with more severe coronary disease, specifically higher SYNTAX score tertiles (tertile 2 and 3). A numerical trend toward higher Lp(a) with worse MADS2 cerebrovascular or peripheral vascular disease scores did not reach statistical significance in this small sample. The authors conclude Lp(a) tracks with coronary disease severity in this South Asian population, an ethnicity with disproportionately high cardiovascular disease burden, and call for a larger study to confirm its relationship with cerebrovascular and peripheral disease specifically.
Original abstract
Background: Atherosclerotic cardiovascular diseases (ASCVD), including coronary artery disease (CAD), cerebrovascular disease (CVD), and peripheral vascular disease (PVD), remain the leading cause of death globally. South Asians exhibit a higher incidence of cardiovascular diseases than other ethnicities, attributed to a range of genetic, environmental, and lifestyle factors. Lipoprotein(a) [Lp(a)] with a unique apolipoprotein(a) component, has emerged as a marker of atherosclerosis and ASCVD risk, with evidence to promote arterial plaque formation and thrombogenesis.
Objective: The aim of this study was to explore the associations between Lp(a) levels and the severity of CAD, CVD, and PVD in a group of South Asian patients.
Methods: Following ethical approval, 60 consecutive patients who underwent coronary angiography for any indication were reviewed. There were 51 eligible participants who were evaluated for Lp(a) level, Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score, and severity of CVD and PVD. The SYNTAX-I score was calculated using two-observer consensus on coronary angiograms. Assessment of CVD was by ultrasound/Doppler, and PVD by estimating ankle-brachial index using Doppler. The multisite arterial disease score 2 (MADS2) and SYNTAX score tertiles were used to group the patients. Statistical analysis was performed using the SPSS software.
Results And Discussion: In this group, we identified a statistically significant difference with higher Lp(a) levels being associated with more severe coronary disease (SYNTAX tertile 2,3). Despite a numerical trend, statistical significance was not confirmed for Lp(a) levels in relation to MADS2-CVD or MADS2-PVD scores. A larger study may be required to assess these aspects.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.