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Prognostic value of lipoprotein (a) level in patients with coronary artery disease: a meta-analysis

Zhimiao Wang1, Xincheng Zhai2, Mei Xue1

  • 1Department of Cardiology, Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, NO. 16766, Jingshi Road, Jinan city, Jinan, 250014, Shandong Province, China.

Lipids in Health and Disease
|July 10, 2019
PubMed

Insights

Elevated lipoprotein (a) predicts cardiac and cardiovascular events in coronary artery disease (CAD) patients. Measuring lipoprotein (a) may improve risk assessment for individuals with CAD.

Area of Science:

  • Cardiology
  • Clinical Biochemistry
  • Epidemiology

Background:

  • Elevated lipoprotein (a) is a known cardiovascular risk factor.
  • Prognostic utility of lipoprotein (a) in coronary artery disease (CAD) patients remains debated.
  • Conflicting findings necessitate further investigation into lipoprotein (a)'s role in CAD.

Purpose of the Study:

  • To evaluate the prognostic value of elevated lipoprotein (a) in patients with coronary artery disease (CAD).
  • To clarify the association between lipoprotein (a) levels and cardiovascular outcomes in CAD.
  • To determine if lipoprotein (a) can aid in risk stratification for CAD patients.

Main Methods:

  • Systematic literature search of PubMed and Embase databases up to April 2019.
  • Inclusion of observational studies reporting on lipoprotein (a) and cardiac/cardiovascular events in CAD patients.
  • Meta-analysis of pooled multivariable adjusted risk ratios (RR) comparing highest vs. lowest lipoprotein (a) levels.

Main Results:

  • Seventeen studies with 283,328 patients were included.
  • Elevated lipoprotein (a) was independently associated with increased risk of cardiac events (RR 1.78) and cardiovascular events (RR 1.29) in CAD patients.
  • No significant association found between elevated lipoprotein (a) and cardiovascular mortality (RR 1.43) or all-cause mortality (RR 1.35).

Conclusions:

  • Elevated lipoprotein (a) level is an independent predictor of cardiac and cardiovascular events in CAD patients.
  • Lipoprotein (a) measurement shows potential for improving risk stratification in CAD.
  • Further research may refine the role of lipoprotein (a) in managing CAD.
Abstract

Keywords:
Coronary artery diseaseMeta-analysisMortalityPrognosis

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