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Lipoprotein a Combined with Fibrinogen as an Independent Predictor of Long-Term Prognosis in Patients with Acute

Cai-Yan Cui1, Tao Ye1, Lian-Chao Cheng1

  • 1Department of Cardiology, The Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Cardiovascular Disease Research Institute of Chengdu, 82 Qinglong St., Chengdu 610031, China.

Journal of Cardiovascular Development and Disease
|October 26, 2022
PubMed

Insights

Combining lipoprotein(a) [Lp(a)] and fibrinogen improves prediction of major adverse cardiovascular and cerebrovascular events (MACCE) in acute coronary syndrome (ACS) patients. This combined approach offers better prognostic value than individual markers for ACS recurrence.

Area of Science:

  • Cardiology
  • Biomarkers
  • Clinical Prediction

Background:

  • Patients with acute coronary syndrome (ACS) face a significant risk of recurrent major adverse cardiovascular and cerebrovascular events (MACCE).
  • Limited research exists on predicting MACCE in ACS patients using combined lipoprotein(a) [Lp(a)] and fibrinogen levels.
  • This study investigates the combined predictive value of Lp(a) and fibrinogen for long-term MACCE risk in ACS patients.

Purpose of the Study:

  • To evaluate the predictive performance of lipoprotein(a) [Lp(a)] combined with fibrinogen for MACCE in ACS patients.
  • To compare the predictive accuracy of combined Lp(a) and fibrinogen against individual markers.

Main Methods:

  • 804 ACS patients were analyzed, categorized by Lp(a) (≥300 mg/L) and fibrinogen (≥3.08 g/L) levels.
  • Patients were grouped (A, B, C) based on combined Lp(a) and fibrinogen levels.
  • MACCE (all-cause death, non-fatal MI, stroke, revascularization) incidence was compared across groups; prediction models were built and compared using C-index, NRI, and IDI.

Main Results:

  • Group C (high Lp(a) and fibrinogen) showed significantly higher MACCE incidence (p < 0.001).
  • Elevated Lp(a) (≥300 mg/L) and fibrinogen (≥3.08 g/L) were identified as independent MACCE predictors.
  • The model incorporating combined Lp(a) and fibrinogen classification demonstrated improved predictive ability (C-index 0.736) compared to the basic model (C-index 0.694).

Conclusions:

  • Both Lp(a) and fibrinogen, individually and combined, are independent predictors of MACCE in ACS patients.
  • The combination of Lp(a) and fibrinogen offers superior predictive value for MACCE in ACS compared to either marker alone.
  • This combined biomarker approach enhances long-term prognosis prediction for ACS patients.

Keywords:
acute coronary syndromefibrinogenlipoprotein along-term prognosispredictor

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