Impact of Lipoprotein (a) on Long-Term Outcomes in Patients with Coronary Artery Disease Treated with Statin After a First Percutaneous Coronary Intervention.

Abstract

AIMS:

Cardiovascular risk persists despite intensive lipid lowering therapy using statins. Serum levels of lipoprotein (a) [Lp(a)] can be a residual cardiovascular risk for adverse events. Aim of the present study was to evaluate the impact of Lp(a) on long-term clinical outcomes in patients treated with statin after percutaneous coronary intervention.

METHODS:

We prospectively enrolled 3507 consecutive CAD patients who underwent a first percutaneous coronary intervention (PCI) between 1997 and 2011 at our institution. We identified 1768 patients (50.4%) who had treated with statin during PCI. Eligible 1336 patients were stratified to two groups according to Lp(a) levels (median Lp (a) 21.5 mg/dL). The primary outcome was major adverse cardiac events (MACE) including cardiac death and non-fatal acute coronary syndrome.

RESULTS:

MACE occurred 144 (10.8%) including 34 (2.5%) cardiac death and 110 (8.7%) non-fatal ACS during median follow-up period of 1920 days. The cumulative rate of MACE was significantly higher in group with high Lp(a) group (log-rank p=0.0460). Multivariate Cox regression analysis showed a significant correlation between Lp (a) levels treated as a natural logarithm-transformed continuous variable and increased MACE (adjusted HR for MACE 1.28, 95%CI 1.04-1.58, p=0.0184)Conclusion: Elevated levels of Lp(a) is significantly associated with long-term adverse clinical outcomes among CAD patients who received statin therapy after PCI.

• Authors: Satoru Suwa, Manabu Ogita, Katsumi Miyauchi, Taketo Sonoda, Hirokazu Konishi, Shuta Tsuboi, Hideki Wada, Ryo Naito, Tomotaka Dohi, Takatoshi Kasai, Shinya Okazaki, Kikuo Isoda, Hiroyuki Daida
• Journal: Journal of atherosclerosis and thrombosis (J Atheroscler Thromb) Vol. 24 Issue 11 Pg. 1125-1131 (Nov 01 2017) ISSN: 1880-3873 [Electronic] Japan
• PMID: 28321012 (Publication Type: Clinical Trial, Journal Article, Observational Study)

Chemical References

• Biomarkers
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Lipoprotein(a)

Topics

• Aged
• Biomarkers (blood)
• Coronary Artery Disease (blood, drug therapy, surgery)
• Female
• Follow-Up Studies
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Lipoprotein(a) (blood)
• Male
• Middle Aged
• Percutaneous Coronary Intervention
• Prognosis
• Prospective Studies
• Risk Factors