The Association of Lipoprotein(a) and Intraplaque Neovascularization in Patients With Carotid Stenosis: A Retrospective Study

Background: Lipoprotein(a) is increasingly recognised as a major risk factor for atherothrombotic cardiovascular disease. We examined whether plasma lipoprotein(a) concentrations were associated with intraplaque neovascularization (IPN) levels in patients with carotid stenosis and in terms of increasing plaque susceptibility to haemorrhage and rupture. Methods: : We included 85 patients diagnosed with carotid stenosis as confirmed using carotid ultrasound who were treated at Guangdong General Hospital. The IPN level was determined using contrast-enhanced ultrasound through the movement of the microbubbles. Univariate and multivariate binary logistic regression analyses were used to determine whether lipoprotein(a) affected IPN levels, and whether lipoprotein(a), cholesterol, triglyceride, and low-density lipoprotein cholesterol affected IPN levels, respectively. Results: : Lipoprotein(a) was a significant predictor of higher IPN levels in binary logistic regression before adjusting for other risk factors (P = 0.031, odds ratio [OR]: 1.238, 95% confidence interval [CI]: 1.020,1.503) whereas cholesterol, triglyceride, and low-density lipoprotein cholesterol were not predicators of IPN in univariate analysis. After adjusting for other risk factors, including age, diabetes mellitus, and smoking status, lipoprotein(a) remained statistically significant in predicting IPN (P = 0.012, OR: 1.335, 95% CI: 1.065,1.674). Conclusions: : Plasma lipoprotein(a) concentrations were found to be independently associated with higher IPN levels in patients with carotid stenosis, but not cholesterol, triglyceride, or low-density lipoprotein cholesterol. Lowering plasma lipoprotein(a) levels may decrease the risk of cardiovascular and cerebrovascular events.