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Published on: January 28, 2020
Serum lipoprotein(a) predicts 1-year major cardiovascular events in patients after percutaneous coronary intervention
Jie Zhang1,2, Mengyu Liu3, Misbahul Ferdous4
1Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University Jinan 250012, Shandong, China.
Insights
High lipoprotein(a) [Lp(a)] levels are a significant predictor of major adverse cardiovascular events (MACEs) after percutaneous coronary intervention (PCI). This highlights Lp(a) as a crucial factor in assessing residual risk in patients with coronary heart disease.
Area of Science:
- Cardiology
- Atherosclerosis Research
- Cardiovascular Event Prediction
Background:
- Lipoprotein(a) [Lp(a)] is a known predictor of coronary heart disease (CHD) and a key factor in atherosclerosis development.
- Understanding Lp(a)'s role post-percutaneous coronary intervention (PCI) is crucial for managing cardiovascular risk.
Purpose of the Study:
- To evaluate the association between lipoprotein(a) [Lp(a)] levels and major adverse cardiovascular events (MACEs) and readmission rates.
- To assess Lp(a) as a predictor of MACEs in patients who have undergone PCI.
Main Methods:
- A cohort of 1,938 patients with CHD undergoing PCI between 2010 and 2018 were stratified into three groups based on Lp(a) levels.
- One-year follow-up was conducted to record MACEs and readmission rates.
- Multivariate Cox regression analysis and Kaplan-Meier survival curves were used to analyze the data.
Main Results:
- Higher Lp(a) levels correlated significantly with increased incidence of MACEs and repeat PCI (re-PCI).
- Lp(a) was identified as an independent predictor of MACEs, even in patients with low-density lipoprotein-cholesterol (LDL-C) below 100 mg/dL.
- A predictive nomogram for 1-year MACEs demonstrated high accuracy.
Conclusions:
- Elevated Lp(a) levels represent a residual risk factor for MACEs in patients with LDL-C below 100 mg/dL post-PCI.
- Lp(a) independently predicts 1-year MACEs, informing risk assessment and clinical strategy selection.
- The developed nomogram accurately predicts 1-year MACEs.
Background:
Lipoprotein(a) [Lp(a)], which is predictive of coronary heart disease (CHD), plays an important role in the pathogenesis of atherosclerosis. This study aimed to evaluate the association of Lp(a) with major adverse cardiovascular events (MACEs) and readmission in individuals who had undergone a percutaneous coronary intervention (PCI).
Methods:
A total of 1,938 patients with CHD who had undergone a PCI from January 2010 to December 2018 were assigned to three groups based on Lp(a) level. Follow-up was performed to assess the 1-year occurrence of MACEs and readmission.
Results:
Kaplan-Meier survival curves showed that the cumulative hazard incidence rate of MACEs and repeat PCI (re-PCI) significantly increased with Lp(a) level. Multivariate Cox proportional hazards regression analysis further confirmed Lp(a) as a significant independent predictor of MACEs. The area under the curve of the complex index risk score was significantly larger than those of other independent indicators. In individuals with low-density lipoprotein-cholesterol (LDL-C) levels either below 70 mg/dL or between 70 mg/dL and 100 mg/dL, Lp(a) was associated with increased rates of MACEs and readmission. In addition, a nomogram was constructed to predict 1-year MACE.
Conclusions:
High Lp(a) levels may be a residual risk factor for MACEs in individuals with LDL-C levels under 100 mg/dL. Additionally, the built nomogram could predict 1-year MACEs with high accuracy. Lp(a) independently predicts 1-year MACEs, indicating its importance in risk assessment and the selection of clinical strategies in patients who have undergone a PCI.
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