Novel lipid biomarkers and ratios as risk predictors for premature coronary artery disease: A retrospective analysis of 2952 patients

Abstract

AbstractThis study examined the associations between emerging lipid biomarkers (small dense low‐density lipoprotein cholesterol [sdLDL‐C), lipoprotein(a) [Lp(a)], and free fatty acids [FFA]), two ratios (sdLDL‐C/LDL‐C and the triglyceride–glucose [TyG) index), and the Gensini score (GS) in patients with premature coronary artery disease (PCAD) in relation to the extent of coronary stenosis. The authors evaluated a cohort of 2952 individuals undergoing coronary angiography (CAG), encompassing those with PCAD (n = 1749), late‐onset coronary artery disease (LCAD; n = 328), and non‐coronary artery disease (non‐CAD; n = 575). Noteworthy differences were observed in the levels of the novel lipid biomarkers and ratio indexes among the PCAD, LCAD, and non‐CAD groups (p < .05). Multiple logistic regression analyses pinpointed Lp(a) (OR = 2.62, 95% CI 1.22–5.63, p = .014) and the TyG index (OR = 2.53, 95% CI 1.08–5.93, p = .033) as independent risk factors for PCAD. Furthermore, these biomarkers and ratio indexes discerned substantial distinctions among PCAD patients with varying GS (p < .05). Consequently, these markers can proficiently anticipate the gravity of coronary artery stenosis (GS > 40) in PCAD patients, as evidenced by the ROC analysis. In conclusion, sdLDL‐C, Lp(a), FFA, and the sdLDL‐C/LDL‐C and TyG indexes have considerable potential as risk and diagnostic markers for coronary artery stenosis in individuals afflicted with PCAD.