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2026№6

Prevalence of elevated lipoprotein(a) level in the blood of patients with acute coronary syndrome living in the regional center of the Central Black Earth Region

DOI
https://dx.doi.org/10.18565/therapy.2026.6.59-69

V.P. Mikhin, L.S. Maltseva, N.L. Kostina, T.A. Nikolenko, G.V. Panchenko, K.A. Elagina

1) Kursk State Medical University, Kursk, Russian Federation; 2) Kursk City Clinical Hospital of Emergency Medical Care, Kursk, Russian Federation
Introduction. The prevalence of elevated lipoprotein(a) (Lp(a)) level in Russia is approximately 20%; however, the level of this marker in acute coronary syndrome (ACS) remains to be poorly understood.
Objective: To evaluate Lp(a) levels in patients with ACS in a limited population consisting of patients at the Kursk regional vascular center of the Kursk City Clinical Hospital of Emergency Medical Care (KCCHEM).
Material and methods. The study included 250 patients hospitalized for ACS in the cardiology department of the KCCHEM. Serum Lp(a) and low-density lipoprotein cholesterol levels were measured on days 5–6 of hospitalization. ACS outcome and the presence of comorbidities were assessed.
Results. Elevated Lp(a) levels were detected in 82 (32.8%) patients with ACS. Of these, 30 (12%) had borderline values (75–125 nmol/L), and 52 (20.8%) had blood levels exceeding 125 nmol/L. Low-density lipoprotein cholesterol levels exceeding the target were observed in 180 (72.0%) patients. Participants with Lp(a) > 75 nmol/L were characterized by earlier manifestation of coronary heart disease (CHD) and higher adherence to lipid-lowering therapy. Post-infarction cardiosclerosis and diabetes mellitus were more frequently observed in patients with Lp(a) > 75 nmol/L. The structure of ACS outcomes (unstable stenocardia, myocardial infarction with and without ST-elevation) did not depend on Lp(a) level. The frequency of indications for coronary artery bypass graft surgery was higher in patients with high Lp(a) levels. The obtained results for the first time demonstrate the prevalence of hyperlipoproteinemia(a) in the regional center of the Black Earth Region and are consistent with data from the Russian REGION-IM registry, which found no association between high Lp(a) level and the type of myocardial infarction (with or without ST-elevation). Individuals with hyperlipoproteinemia(a) were found to be more likely to adhere to lipid-lowering therapy, which is due to a more severe course of coronary heart disease (CHD) preceding ACS.
Conclusion. Elevated Lp(a) levels are associated with earlier manifestation of CHD, a higher incidence of post-infarction cardiosclerosis, coronary artery bypass grafting, and diabetes mellitus, indicating a more severe course of atherosclerosis.

Keywords

acute coronary syndrome
myocardial infarction
hyperlipidemia
lipoprotein(a)
Full text (in Russian)

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About the Authors

Vadim P. Mikhin, MD, Dr. Sci. (Medicine), professor, head of the Department of internal medicine No. 2, Kursk State Medical University, Kursk, Russian Federation.
E-mail: mikhinvp@kursksmu.net
ORCID: https://orcid.org/0000-0002-5398-9727. eLibrary SPIN: 5986-0531.
Lina S. Maltseva, MD, PhD (Medicine), associate professor, Department of internal medicine No. 2, Kursk State Medical University, Kursk, Russian Federation.
E-mail: lmal0785@rambler.ru
ORCID: https://orcid.org/0009-0002-4467-371X. eLibrary SPIN: 7235-3415.
Nadezhda L. Kostina, MD, PhD (Medicine), associate professor of the Department of internal medicine No. 2, Kursk State Medical University, Kursk, Russian Federation.
E-mail: costinanl@yandex.ru
ORCID: https://orcid.org/0000-0002-2835-4762. Scopus ID: 59399640500. eLibrary SPIN: 5684-3869.
Tamara A. Nikolenko, MD, PhD (Medicine), associate professor of the Department of internal medicine No. 2, Kursk State Medical University, Kursk, Russian Federation.
Email: tomik7@yandex.ru
ORCID: https://orcid.org/0000-0001-7987-9000. Scopus ID: 57195805641. eLibrary SPIN: 1930-1943.
Galina V. Panchenko, MD, head of the Department of cardiology with primary care intensive care unit, Kursk City Clinical Hospital of Emergency Medical Care, Kursk, Russian Federation.
E-mail: gvpanchenko1963@gmail.com
Karina A Elagina, MD, cardiologist of the Department of cardiology with primary care intensive care unit, Kursk City Clinical Hospital of Emergency Medical Care, Kursk, Russian Federation.
E-mail: karina.boeva.95@mail.ru

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Erlikh A.D., Terekhin S.A., Shornikov S.B.
Some nuances of management of antiplatelet therapy in patients with acute coronary syndrome and atrial fibrillation using apixaban
№7 / 2024
Kadnikov L.I., Izmozherova N.V., Popov A.A., Antropova I.P.
Estimation of the platelet component of hemostasis in COVID-19 patients
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