This study aimed to investigate the impact of
high-sensitivity C-reactive protein (
hsCRP) on
Lipoprotein(a) [Lp(a)] associated cardiovascular risk in patients with
ST-segment elevation myocardial infarction (
STEMI) underwent
percutaneous coronary intervention (PCI). A total of 2318
STEMI-PCI patients were retrospectively recruited, and further stratified based on postprocedural
hsCRP levels (≥ 2 vs < 2 mg/L).
Major adverse cardiac events (
MACE) were defined as all-cause death,
myocardial infarction and
stroke. During a mean follow-up of 2.5 years,
MACE occurred in 159 (6.9%) patients. In the setting of
hsCRP ≥ 2mg/L, per unit increase of Lp(a) was associated with a 28% increase of
MACE risk (HR: 1.28, 95% CI: 1.09 to 1.49, p = 0.002; p = 0.031 for interaction); increasing tertiles of Lp(a) were significantly related to greater rates of
MACE (p = 0.011 for interaction; p = 0.005 for trend across tertiles). Patients with upper tertile of Lp(a) had a significant lower event-free survival (p = 0.034) when
hsCRP ≥ 2mg/L. No similar association between Lp(a) and
MACE was noted when
hsCRP < 2mg/L. In conclusion, high Lp(a) levels were associated with poor prognosis when
hsCRP ≥ 2mg/L, implying systemic
inflammation can modulate Lp(a)-associated
MACE risk in
STEMI-PCI patients. Measurement of Lp(a) in patients with high
inflammation risk may identify individuals at high cardiovascular risk.