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Association of Lipoprotein(a) With Recurrent Ischemic Events Following Percutaneous Coronary Intervention

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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)
강도윤강수진김영학박덕우박성욱박승정안정민윤용훈이승환이철환이필형한기훈
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
Appears in Collections:
Medicine > Medicine
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