Abstract: Objective To explore the relationship between lipoprotein(a) [Lp(a)] and perioperative myocardial injury(PMI) in the elderly patients with coronary heart disease(CHD). Methods A total of 200 elderly patients with CHD who received PCI in Yixing People's Hospital from January 2020 to March 2021 were enrolled in this study. According to the level of troponin T (cTnT), the patients were divided into the observation group with elevated cTnT level (n=106) and the control group with normal cTnT level (n=94), and the differences in all the clinical data between the two groups were analyzed. According to SYNTAX score, the patients were divided into low score group (0-22), middle score group (23-32) and high score group (≥33). The level of Lp(a) was detected and compared among all groups. Results The levels of age and Lp(a), the numbers of the stents and the total length of the stents were significant higher in the observation group than those in the control group(P<0.05). According to SYNTAX score, the level of Lp(a) in the low score group, the middle score group and the high score group was 168.29±28.97 mg/L, 294.72±28.25 mg/L and 465.29±48.62 mg/L, respectively, with significant differences among the three groups (P<0.05). The Logistic regression analysis showed that age(OR=1.106, 95%CI: 1.044-1.171), Lp(a)(OR=2.291, 95%CI: 1.150-4.562), total length of the stents(OR=1.015, 95%CI: 1.004-1.027)were the independent influencing factors of PMI. Conclusions The preoperative high level of Lp(a) is a risk factor of PMI after PCI in the elderly patients with CHD. Lp(a) has a positive relationship with the severity of coronary lesions.

Key words: lipoprotein(a), coronary heart disease, percutaneous coronary intervention, perioperative myocardial injury, aged