Background  Lipoprotein(a) Lp(a) is a special kind of lipoprotein cholesterol which has been regarded as an independent risk factor for coronary atherosclerosis.

  Objective  To investigate the association between Lp(a) and severity of coronary artery disease.

  Methods  A total of 195 patients who accepted coronary computed tomography angiography (CCTA) scan for suspected coronary artery disease (CAD) from January 2016 to December 2018 were enrolled in this study. The correlation analysis was performed to detect the association between Lp(a) and CCTA-based anatomical quantitative scores, such as segment involvement score (SIS), segment stenosis score (SSS) and Leiden score. Patients were divided into obstructive CAD group (n=74) and non-obstructive CAD group (n=121) according to coronary luminal stenosis. Further Logistic regression analysis was conducted to determine the independent risk factors of obstructive CAD.

  Results  There were weak positive linear relationships between the Lp(a) levels and SIS (r=0.175, P=0.015), SSS (r=0.172, P=0.016), Leiden score (r=0.187, P=0.009). Age (OR=1.048, 95% CI: 1.015-1.083, P=0.005), fasting blood glucose (OR=1.461, 95% CI: 1.179-1.811, P=0.001) and Lp(a) (OR=2.407, 95% CI: 1.133-5.115, P=0.022) were independent risk factors for obstructive CAD after adjusting for traditional risk factors.

  Conclusion  Lp(a) levels have weak positive linear relationship with severity of coronary artery disease based on CCTA anatomical quantitative scores. Lp(a) is an independent risk factor for obstructive CAD.