Forecasting risk analysis of detection for carotid artery stenosis based on serum levels grading of lipoprotein (a)
United Hospital with Outpatient Department of the Administrative Department of the President of the Russian Federation, 6 Michurinskii Ave., Moscow, 119285, Russian Federation
Aim of the study: to assess the relationship between Lp(a) serum levels grading and carotid artery stenosis (CAS).
The Duplex Registry database was used for this study. CAS was verified by duplex scanning in the presence of an atherosclerotic plaque (AP), stenosing the lumen of the carotid artery (CA) by 20 % or more. Patients who underwent a blood test for Lp(a) and the results were entered into the registry database were selected for this study. The immunoturbidimetric method was used to determine the serum level of Lp(a) (mg/dl).
Data from 51 patients (66.6 % men) were included in the final analysis: median age 49.0 [46.0; 59], total cholesterol (TC) 5.93 [5.13; 6.56], Lp(a) 26.5 [14.2; 76.0]. Spearman rank correlation analysis showed the presence of significant relationships (p < 0.05) between Lp(a) and age (r = 0.3), gender (r = 0.3), the presence of AP in the right ICA (r = 0.5), HDL (r = 0.3). OR and 95 % CI were calculated to determine the effect of Lp(a) grades on the probability of CAS detection: Lp(a) < 30 mg/dl OR 0.36 [0.11; 1.14] p = 0.04; Lp(a) > 30 mg/dl OR 1.42 [0.44; 4.58] p = 0.27. The prevalence of CAS in the group with Lp(a) level < 30 mg/dl was 33.3 %, 30–50 mg/dl – 50 %, 50–100 mg/dl – 40 %, > 100 mg/dl – 37.5 %. The model of multiple regression analysis for Lp(a) with TC in relation to the right ICA stenosis predicting showed R = 0.51, F = 8.4, p = 0.0007. The statistics of 3M model of the logistic regression function for CAS predicting based on the Lp(a) and TC data showed: -2 • log(likelihood) = 57.16, Chi-square = 8.17 (cc = 2), p = 0.016.
The present study confirmed the relationship between the Lp(a) level and the CAS detection and the presence of an additive effect of total cholesterol on this. The reference role of Lp(a) gradation at the level of 30 mg/dl was determined as significant in relation to predicting CAS detection.
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