Association of Lipoprotein(a) With Recurrent Ischemic Events Following Percutaneous Coronary Intervention
- Abstract
- Objectives: This study evaluated the association between elevated levels of lipoprotein(a) [Lp(a)] and risk of recurrent ischemic events in patients who underwent percutaneous coronary intervention (PCI).
Background: Elevated levels of Lp(a) have been identified as an independent, possibly causal, risk factor for atherosclerotic cardiovascular disease in a general population study.
Methods: A prospective single-center registry was used to identify 12,064 patients with baseline Lp(a) measurements who underwent PCI between 2003 and 2013. The primary outcomes were a composite of cardiovascular death, spontaneous myocardial infarction, and ischemic stroke.
Results: From the registry, 3,747 (31.1%) patients had high Lp(a) (>30 mg/dL) and 8,317 (68.9%) patients had low Lp(a) (≤30 mg/dL). During a median follow-up of 7.4 years, primary outcomes occurred in 1,490 patients, and the incidence rates of primary outcomes were 2.0 per 100 person-years in the high-Lp(a) group and 1.6 per 100 person-years in the low-Lp(a) group (adjusted hazard ratio [aHR]: 1.17; 95% confidence interval [CI]: 1.05-1.30; P = 0.004). Increased risk of recurrent ischemic cardiovascular events in the high-Lp(a) group was consistent in various subgroups including patients receiving statin treatment at discharge (aHR: 1.18; 95% CI: 1.03-1.34; P = 0.011). In addition, the risk of repeated revascularization was significantly higher in the high-Lp(a) group (aHR: 1.13; 95% CI: 1.02-1.25; P = 0.022).
Conclusions: Elevated levels of Lp(a) were significantly associated with the recurrent ischemic events in patients who underwent PCI. This study provides a rationale for outcome trials to test Lp(a)-lowering therapy for secondary prevention in patients undergoing PCI.
Keywords: coronary disease; lipoprotein (a); prognosis; stent.
- Author(s)
- 강도윤; 강수진; 김영학; 박덕우; 박성욱; 박승정; 안정민; 윤용훈; 이승환; 이철환; 이필형; 한기훈
- Issued Date
- 2021
- Type
- Article
- Keyword
- 2021A02280과 중복논문
- URI
- https://oak.ulsan.ac.kr/handle/2021.oak/7226
- Publisher
- JACC-Cardiovascular Interventions
- Location
- 미국
- Language
- 영어
- ISSN
- 1936-8798
- Citation Volume
- 14
- Citation Number
- 18
- Citation Start Page
- 2059
- Citation End Page
- 2068
-
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- Medicine > Medicine
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