Lipoprotein(a) and the risk of type I cardiorenal syndrome in patients with coronary artery disease: A retrospective clinical study

Objective: The present study aimed to investigate the correlation between lipoprotein(a) (Lp-a) and coronary artery disease (CAD) complicated by type I cardiorenal syndrome (CRS).

Methods: We conducted a retrospective analysis of patients diagnosed with CAD admitted to the Department of Cardiovascular Medicine at Shaoxing Central Hospital from January 2021 to December 2022, with chief complaints of "chest distress and dyspnea." Patient demographic data, biochemical indicators (including blood lipid levels and serum creatinine), cardiac function markers (such as pro-brain natriuretic peptide, pro-BNP), echocardiography, and coronary angiography results were collected. Patients were categorized into two groups based on estimated glomerular filtration rate (e-GFR): the CRS group (e-GFR < 60 mL/min/1.73 m²) and the simple heart failure group (SHF group, e-GFR ≥ 60 mL/min/1.73 m²). A comparative analysis of baseline characteristics, lipid profiles, ejection fraction (LVEF), left atrial size (LA), end-diastolic interventricular septal thickness (IVSd), left ventricular end-diastolic dimension (LVEDD), and left ventricular end-systolic dimension (LVESD) between the two groups was performed. Multivariable logistic regression analysis was applied to assess the association between serum lipoprotein(a) (Lp-a) levels and the occurrence of CRS.

Results: A total of 269 patients were included, comprising 149 males and 120 females with an average age of 76.0 ± 11.4 years. Significant differences were observed between the CRS and SHF groups in terms of age, history of hypertension, diabetes, myocardial infarction, serum triglycerides, Lp-a, and creatinine (all P < 0.05). Spearman's correlation analysis revealed an inverse relationship between Lp-a and e-GFR (r = -0.588, P < 0.05). Multivariable logistic regression analysis indicated that Lp-a (OR = 1.980, 95 % CI: 1.269-2.992, P = 0.027) and age (OR = 1.584, 95 % CI: 0.955-1.913, P = 0.006) were positively associated with the development of CRS.

Conclusion: Serum Lp-a levels are positively correlated with the occurrence of CRS, potentially serving as an independent risk factor for CRS.