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Lipoprotein (a) is a residual risk of atherosclerotic renal artery stenosis in hypertensive patients: a hospital-based cross-sectional study
Haojian Dong
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4388-8623
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Lipids in Health and Disease.
Background: Low-density lipoprotein cholesterol (LDL-c) has been proven to be a risk factor for atherosclerotic cardiovascular disease (CVD), while lipoprotein (a) (Lp(a)) is a residual risk factor for CVD, even though LDL-c is well controlled by statin use. Importantly, the role of Lp(a) in atherosclerotic renal artery stenosis (ARAS) is still unknown.
Methods: For this hospital-based cross-sectional study, patients who simultaneously underwent coronary and renal angiography were examined. ARAS was defined as a 50% reduction in the cross-sectional (two-dimensional plane) area of the renal artery. Data were collected and compared between ARAS and non-ARAS groups, including clinical history and metabolite profiles. Univariate analysis, three tertile LDL-c-based stratified analysis, and multivariate-adjusted logistic analysis were conducted, revealing a correlation between Lp(a) and ARAS.
Results: A total of 170 hypertensive patients were included in this study, 85 with ARAS and 85 with non-RAS. Baseline information indicated comparability between the two groups. In the univariate and multivariate analysis, common risk factors for atherosclerosis were not significantly different. Stratified analysis of LDL-c revealed a significant increase in the incidence of ARAS in patients who had high Lp(a) concentrations at low LDL-c levels (odds ratio (OR): 4.77, 95% confidence interval (CI): 1.04-21.79, P = 0.044). Further logistic analysis with adjusted covariates also confirmed the result, indicating that high Lp(a) levels were independently associated with ARAS (adjusted OR (aOR): 6.14, 95%CI: 1.03-36.47, P = 0.046). This relationship increased with increasing Lp(a) concentration based on a curve fitting graph. These results were not present in the low and intermediate LDL-c-level groups.
Conclusion: In hypertensive patients who present low LDL-c, high Lp(a) was significantly associated with atherosclerotic renal artery stenosis and thus is a residual risk factor.
Keywords
Lipoprotein (a); atherosclerotic renal artery stenosis; LDL-cholesterol; residual risk
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This preprint is under consideration at Lipids in Health and Disease. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Lipoprotein (a) is a residual risk of atherosclerotic renal artery stenosis in hypertensive patients: a hospital-based cross-sectional study
Haojian Dong
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4388-8623
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 12 May, 2020
Published
On 23 Jul, 2020
No community comments so far
Editorial decision: Accept
On 28 Apr, 2020
Editor assigned
On 27 Apr, 2020
Submission checks complete
On 26 Apr, 2020
Editor invited
On 26 Apr, 2020
No comments provided
Review #2 received
Received 20 Apr, 2020
Editorial decision: Minor revision
On 20 Apr, 2020
Review #3 received
Received 16 Apr, 2020
Reviewers invited
Invitations sent on 16 Apr, 2020
Reviewer #1 agreed
On 16 Apr, 2020
Reviewer #2 agreed
On 16 Apr, 2020
Reviewer #3 agreed
On 16 Apr, 2020
Review #1 received
Received 16 Apr, 2020
Editor assigned
On 16 Apr, 2020
Submission checks complete
On 15 Apr, 2020
Editor invited
On 15 Apr, 2020
No comments provided
Editorial decision: Major revision
On 16 Mar, 2020
Reviewer #8 agreed
On 15 Mar, 2020
Review #8 received
Received 15 Mar, 2020
Review #5 received
Received 15 Mar, 2020
Review #7 received
Received 12 Mar, 2020
Reviewer #7 agreed
On 12 Mar, 2020
Review #1 received
Received 08 Mar, 2020
Review #6 received
Received 03 Mar, 2020
Review #3 received
Received 03 Mar, 2020
Review #2 received
Received 02 Mar, 2020
Reviewer #6 agreed
On 02 Mar, 2020
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Received 02 Mar, 2020
Reviewer #4 agreed
On 01 Mar, 2020
Reviewer #5 agreed
On 01 Mar, 2020
Reviewer #3 agreed
On 26 Feb, 2020
Reviewers invited
Invitations sent on 22 Feb, 2020
Reviewer #1 agreed
On 22 Feb, 2020
Reviewer #2 agreed
On 22 Feb, 2020
Editor assigned
On 07 Feb, 2020
Submission checks complete
On 06 Feb, 2020
Editor invited
On 06 Feb, 2020
First submitted
On 02 Feb, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Lipids in Health and Disease.
Background: Low-density lipoprotein cholesterol (LDL-c) has been proven to be a risk factor for atherosclerotic cardiovascular disease (CVD), while lipoprotein (a) (Lp(a)) is a residual risk factor for CVD, even though LDL-c is well controlled by statin use. Importantly, the role of Lp(a) in atherosclerotic renal artery stenosis (ARAS) is still unknown.
Methods: For this hospital-based cross-sectional study, patients who simultaneously underwent coronary and renal angiography were examined. ARAS was defined as a 50% reduction in the cross-sectional (two-dimensional plane) area of the renal artery. Data were collected and compared between ARAS and non-ARAS groups, including clinical history and metabolite profiles. Univariate analysis, three tertile LDL-c-based stratified analysis, and multivariate-adjusted logistic analysis were conducted, revealing a correlation between Lp(a) and ARAS.
Results: A total of 170 hypertensive patients were included in this study, 85 with ARAS and 85 with non-RAS. Baseline information indicated comparability between the two groups. In the univariate and multivariate analysis, common risk factors for atherosclerosis were not significantly different. Stratified analysis of LDL-c revealed a significant increase in the incidence of ARAS in patients who had high Lp(a) concentrations at low LDL-c levels (odds ratio (OR): 4.77, 95% confidence interval (CI): 1.04-21.79, P = 0.044). Further logistic analysis with adjusted covariates also confirmed the result, indicating that high Lp(a) levels were independently associated with ARAS (adjusted OR (aOR): 6.14, 95%CI: 1.03-36.47, P = 0.046). This relationship increased with increasing Lp(a) concentration based on a curve fitting graph. These results were not present in the low and intermediate LDL-c-level groups.
Conclusion: In hypertensive patients who present low LDL-c, high Lp(a) was significantly associated with atherosclerotic renal artery stenosis and thus is a residual risk factor.
Figure 1
Figure 2
Figure 3