GIÁ TRỊ CỦA LIPOPROTEIN (A) TRONG DỰ ĐOÁN MỨC ĐỘ NẶNG CỦA HẸP MẠCH VÀNH Ở BỆNH ĐỘNG MẠCH VÀNH MẠN

Abstract

Background: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. Lipoprotein (a) has emerged as an independent risk factor for CAD, but its role in predicting coronary severity in Vietnamese populations remains unclear. Objectives: To evaluate the prognostic value of Lp(a) in assessing the severity of coronary artery stenosis in chronic CAD. Methods: This cross-sectional study was conducted at Tam Anh General Hospital from June 2024 to June 2025, including 138 patients diagnosed with chronic CAD. Demographic, clinical, laboratory, and coronary angiographic data were collected. CAD severity was assessed using the Gensini score. Logistic regression and ROC analysis were employed to evaluate the prognostic value of Lp(a). Results: Severe CAD (Gensini > 40) was present in 31.9% of the cohort. Patients with Lp(a) ≥ 30 mg/dL exhibited a significantly higher prevalence of severe CAD (72.5% vs 8.0%). Lp(a) levels correlated strongly with the Gensini score. The optimal cut-off for predicting severe CAD was 30.6 mg/dL (AUC = 0.869). Multivariate analysis confirmed Lp(a) as an independent predictor. Conclusions: Lp(a) ≥30 mg/dL is strongly associated with severe coronary artery stenosis. Lp(a) is a valuable independent predictor of CAD severity and may serve as an essential tool for risk stratification in clinical practice.