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Association of lipoprotein(a) with platelet aggregation and thrombogenicity in patients undergoing percutaneous

Pei Zhu1, Xiao-Fang Tang1, Ying Song1

  • 1Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

Platelets
|August 14, 2020
PubMed

Insights

High lipoprotein(a) levels in patients undergoing percutaneous coronary intervention (PCI) are linked to increased platelet aggregation and a higher risk of ischemic events. This suggests lipoprotein(a) may guide the duration of antiplatelet therapy.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Chemistry
  • Hematology

Background:

  • Lipoprotein(a) [Lp(a)] is an emerging cardiovascular risk factor.
  • Platelet aggregation and thrombogenicity are critical in percutaneous coronary intervention (PCI).
  • The role of Lp(a) in platelet function and ischemic outcomes post-PCI requires further elucidation.

Purpose of the Study:

  • To assess the association between lipoprotein(a) levels and platelet aggregation/thrombogenicity in PCI patients.
  • To investigate the relationship between Lp(a) and ischemic outcomes following PCI.
  • To explore Lp(a) as a potential marker for guiding antiplatelet therapy duration.

Main Methods:

  • Prospective study of 6601 consecutive patients undergoing PCI on dual antiplatelet therapy.
  • Measurement of lipoprotein(a) levels and modified thrombelastography (including platelet mapping).
  • Two-year follow-up for major adverse cardiovascular and cerebrovascular events using Cox proportional regression analysis.

Main Results:

  • Higher Lp(a) levels correlated with accelerated fibrin generation and increased clot strength.
  • Patients with higher Lp(a) showed significantly greater adenosine diphosphate (ADP)-induced platelet aggregation.
  • Elevated Lp(a) was associated with a 16% increased risk of major adverse cardiovascular and cerebrovascular events post-PCI, persisting after risk factor adjustment.

Conclusions:

  • High plasma Lp(a) levels are associated with enhanced platelet aggregation and thrombogenicity in PCI patients.
  • Elevated Lp(a) predicts a higher risk of ischemic events after PCI.
  • Lp(a) may serve as a biomarker to identify patients who could benefit from prolonged antiplatelet therapy.

Keywords:
Lipoprotein(a)major adverse cardiovascular and cerebrovascular eventspercutaneous coronary interventionplatelet aggregationthrombelastography

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