Plasma lipoprotein(a) levels are associated with chronic kidney disease and venous calcification in patients undergoing coronary artery bypass grafting
Y Shin, J Ryu, E H Jang, H H Kim, S J Park, Y N YounAbstract
Background/Introduction
Patients with chronic kidney disease (CKD) face heightened risks of vascular calcium deposition and poorer outcomes following coronary artery bypass grafting (CABG). Lipoprotein(a) [Lp(a)] is a recognized cardiovascular risk factor. However, the association between plasma Lp(a) levels, CKD, and venous calcium deposition in patients undergoing CABG remains poorly understood.
Purpose
This study aimed to evaluate the association of plasma Lp(a) levels with CKD and to assess venous calcium content according to CKD status in patients undergoing CABG.
Methods
Patients undergoing CABG were categorized into non-CKD and CKD groups. Plasma Lp(a) levels were measured using an enzyme-linked immunosorbent assay (ELISA). To estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the presence of CKD, Lp(a) and conventional lipid parameters—including total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides—were individually entered into univariable logistic regression models. To evaluate calcium deposition, calcium content in saphenous vein tissues was quantitatively measured using inductively coupled plasma mass spectrometry (ICP-MS) and compared between the groups. Statistical significance was defined as P < 0.05.
Results
Among a total of 42 patients, plasma Lp(a) levels were significantly higher in the CKD group (median 20.3 mg/dL) compared to the non-CKD group (median 8.4 mg/dL) (P < 0.05). In univariable logistic regression analysis, higher plasma Lp(a) levels were associated with increased odds of CKD (OR: 1.056, 95% CI: 1.012–1.118, P = 0.010). Conversely, conventional lipid parameters (total cholesterol, HDL-C, LDL-C, and triglycerides) demonstrated no significant association with CKD status (all P > 0.05). Subsequently, ICP-MS analysis revealed significantly higher calcium content in saphenous veins from the CKD group (median 72.1 µg/g tissue) compared with the non-CKD group (median 27.9 µg/g tissue) (P = 0.0207).
Conclusion(s)
Plasma Lp(a) levels are associated with the presence of CKD in patients undergoing CABG. In addition, patients with CKD exhibit significantly higher calcium content in saphenous vein grafts. These findings suggest a potential link between CKD, Lp(a), and venous graft calcification in this high-risk surgical population.