Impact of Postprocedural High-Sensitivity C-Reactive Protein on Lipoprotein(a)-Associated Cardiovascular Risk with...

Area of Science:

• Cardiology
• Biomarkers
• Inflammation Research

Background:

• Lipoprotein(a) [Lp(a)] is an established cardiovascular risk factor.
• Systemic inflammation, indicated by high-sensitivity C-reactive protein (hsCRP), is prevalent in ST-segment elevation myocardial infarction (STEMI) patients.
• The interplay between Lp(a) and hsCRP in STEMI patients undergoing percutaneous coronary intervention (PCI) requires further investigation.

Purpose of the Study:

• To investigate the impact of hsCRP on Lp(a)-associated cardiovascular risk in STEMI patients post-PCI.
• To determine if elevated hsCRP modifies the association between Lp(a) levels and major adverse cardiac events (MACE).

Main Methods:

• Retrospective analysis of 2318 STEMI-PCI patients.
• Stratification based on postprocedural hsCRP levels (≥ 2 mg/L vs < 2 mg/L).
• Assessment of MACE (all-cause death, myocardial infarction, stroke) over a mean 2.5-year follow-up.

Main Results:

• In patients with hsCRP ≥ 2 mg/L, elevated Lp(a) was significantly associated with increased MACE risk (HR: 1.28, p=0.002).
• Higher Lp(a) tertiles correlated with greater MACE rates in the high hsCRP group (p=0.005).
• No significant association between Lp(a) and MACE was observed when hsCRP < 2 mg/L.

Conclusions:

• High Lp(a) levels confer a poor prognosis in STEMI-PCI patients with elevated hsCRP (≥ 2 mg/L).
• Systemic inflammation appears to modulate the cardiovascular risk associated with Lp(a).
• Measuring Lp(a) in patients with high inflammation may identify individuals at elevated cardiovascular risk.