Objective To explore the correlation between lipoprotein (a) or Lp(a) and severity of coronary artery stenosis and its predictive value of major adverse cardiovascular events (MACE) in elderly patients with coronary artery disease (CAD).

Methods A total of 693 elderly patients with CAD who were admitted to the Department of Cardiology, Zhongshan Hospital, Fudan University from January 2014 to December 2014 for percutaneous coronary intervention (PCI) were selected. The serum Lp (a) level was detected and the severity of coronary artery stenosis was calculated according to the Gensini score on patient admission. The serum Lp (a) level changes and MACE were followed up.

Results The patients were divided into three groups according to the Lp (a) levels. There was statistically significant difference (P < 0.05) in Gensini score among the three groups. The levels of LDL-C and InLp (a) were independently correlated with the degree of coronary artery stenosis after adjusting for multiple risk factors (P < 0.05). A total of 91 cases of MACE occurred during the follow-up, and Lp (a) level was an independent influencing factor of MACE (P < 0.05). According to whether MACE occurred or not, patients were divided into the MACE group and non-MACE group. LDL-C level was similar in the two groups at baseline and during follow-up. Lp (a) in MACE group was significantly higher than that in non-MACE group during follow-up (P < 0.05). The area under curve (AUC) of Lp (a) level was 0.582 (95% CI 0.511-0.652). The predicted sensitivity was 61.5%, and the specificity was 54.9% with a cut-off value of 151 mg/L (15.10 mg/mL) of the serum Lp (a).

Conclusions Lp (a) may be an independent risk factor for predicting the degree of coronary stenosis in patients with CAD. Lp (a) level is related to the occurrence of MACE with the same level of LDL-C.