The association between the levels of serum lipids and lipoproteins and coronary artery disease(CAD) was well established. This study examines to assess the relation of the concentrations of serum lipids and lipoproteins to the severity of coronary atherosclerosis quantified by angiography.

We studied 72 patients(men 47, women 25 and mean age 55.6 years) who underwent coronary arteriography for suspected coronary artery disease. Coronary lesion scores were represented by estimates of stenosis in four major coronary vessels. We determined the levels of serum total cholesterol, triglyceride and HDL-cholesterol by biochemical methods. Serum apolipoprotein A-I, apolipoprotein B and lipoprotein(a) were quantified by radioimmunoassay.

The distribution of Lp(a)levels among the subject population was highly skewed, with a mean Lp(a) level of 20.0mg/dL and a median of 15.2mg/dL. Coronary lesion scores significantly correlated with Lp(a), HDL-cholesterol levels and the age of patient by univariate statistical analysis. By multivariate analysis, levels of Lp(a) were associated significantly and independently with lesion scores and tend to correlate with the presence of CAD. In men, overall lesion severity of coronary atherosclerosis was related to Lp(a) levels, whereas in women it was related to apolipoprotein B levels by multiple regression anaylsis.

The serum Lp(a) may be considerably more reliable index of advanced coronary artery disease than other lipids and lipoproteins, especially in men.