Correlation between Serum Lipoprotein(a) Levels and Severity of Coronary Artery Disease in Young Adults Under 45

Introduction: The death and disability rates from coronary artery disease (CAD) are substantial even in adults under 45, but traditional risk factors such as hypertension, diabetes mellitus, smoking, and dyslipidemia don’t fully explain its early onset. Genetically programmed lipoprotein(a) is becoming more widely acknowledged as a separate risk factor for early-onset coronary artery disease. This study evaluated the relationship involving serum Lp(a) levels and CAD severity in young adults. Materials and Methods: A cross-sectional investigation was carried out at the Cardiology Department of Lady Reading Hospital (LRH), Peshawar, over a period of 12 months from January 2023 to December 2023. Included were 98 subjects who had coronary angiography and were less than 45 years old. Serum Lp(a) levels were measured, and CAD severity was assessed using the Gensini score. Statistical analyses including Pearson correlation, chi-square test, independent t-test, ANOVA, and multivariate linear regression were applied using SPSS version 26. Results: The mean age was 39.2 ± 4.6 years, with 72.4% males and 27.6% females. Elevated Lp(a) levels (>30 mg/dL) were observed in 63.2% of patients. There was a noteworthy positive association between the Gensini score and Lp(a) levels (r = 0.61, p < 0.001). Individuals having severe CAD had significantly more mean Lp(a) levels than those with mild CAD. Multivariate regression analysis confirmed Lp(a) as an independent predictor of CAD severity. Conclusion: Higher Lp(a) values are closely linked to greater angiographic severity of CAD in young adults. Routine screening in young adults with cardiovascular risk factors may aid in early risk identification and prevention.