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Background: Lipoprotein(a) (Lp(a)) excess is an independent risk factor of coronary artery disease (CAD) and
have shown wide ethnic variations. Further, lipid parameters used in the assessment and management of risk
factors for CAD may not reflect accurately the disease or severity if the patients are on pharmacological
interventions when compared to Lp(a). Lp(a) levels of Sri Lankan CAD patients awaiting coronary artery
bypass graft are not documented.
Methods: A cross sectional study was carried out with patients (n = 102) awaiting coronary artery bypass graft
at a tertiary healthcare institution in Sri Lanka. Lp(a) was determined by immunoturbidimetric method
(Konelab 20XT) and information on risk factors collected using a standardized questionnaire. The severity of
CAD was determined by Gensini score. Lipid parameters and pharmacological treatment data were obtained
from the Medical Records. Data were analysed using independent sample t-test, Pearson and Spearman tests
respectively.
Results: Total cholesterol (TC), LDL cholesterol (LDLc) and HDL cholesterol (HDLc) of the total study sample
(average ± SD) were, 150 ± 36 mg/dL, 92 ± 36 mg/dL and 34 ± 9 mg/dL respectively with no significant difference
irrespective of being on pharmacological treatment or not. All lipid parameters were significantly high (p < 0.05) in
females. The average Lp(a) was 50 ± 38 (SD) mg/dL with no significant difference in males or females independent of
being on treatment (50 ± 39 mg/dL) or not (49 ± 39 mg/dL) and above the cut off value (30 mg/dL).
Conclusions: Despite pharmacological interventions 27 % of the study population had high LDLc and majority low
HDLc. Mean Lp(a) was in excess irrespective of risk factors or being on treatment or not and is confirmed as an
independent, potential marker for assessing the susceptibility for CAD especially in those with other intermediate risk
factors but considered non-hyperlipidemic by conventional methods.
