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Lipoprotein(a) and Adverse Outcomes After Successful Percutaneous Coronary Intervention for Chronic Total Occlusion:

Jing Wang1, Qiheng Wan2, Zehan Huang2

  • 1Department of Cardiology, Shenzhen Luohu Hospital Group Luohu People's Hospital, The Third Affiliated Hospital of Shenzhen University, Shenzhen 518000, China.

Journal of Cardiovascular Development and Disease
|July 27, 2026
PubMed

Insights

Elevated Lipoprotein(a) [Lp(a)] significantly increases cardiovascular death risk after successful chronic total occlusion (CTO) percutaneous coronary intervention (PCI). This finding highlights Lp(a) as a key prognostic marker for risk stratification in high-risk patients.

Area of Science:

  • Cardiology
  • Biochemistry

Background:

  • Lipoprotein(a) [Lp(a)] is a known atherogenic and prothrombotic lipoprotein.
  • The prognostic significance of Lp(a) in patients undergoing successful chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is not well-defined.

Purpose of the Study:

  • To investigate the association between Lp(a) levels and cardiovascular outcomes in patients with successful CTO PCI.
  • To determine if Lp(a) can serve as a prognostic marker for risk stratification in this patient population.

Main Methods:

  • A single-center retrospective cohort study of 1509 patients who underwent successful CTO PCI.
  • Primary outcome: cardiovascular death. Secondary outcome: major adverse cardiovascular events (MACEs).
  • Multivariable Cox regression and restricted cubic splines (RCS) were used to analyze Lp(a) and outcomes.

Main Results:

  • Elevated Lp(a) was independently associated with increased risk of cardiovascular death and MACEs.
  • Each 1-SD increase in log-transformed Lp(a) correlated with a 51% higher risk of cardiovascular death and 44% higher risk of MACEs.
  • A linear dose-response relationship was observed between Lp(a) levels and adverse cardiovascular events.

Conclusions:

  • In patients with successful CTO PCI, elevated Lp(a) is an independent predictor of cardiovascular death and MACEs.
  • Lp(a) may enhance risk stratification in this high-risk group.
  • Further prospective studies are needed to validate these findings for clinical application.

Keywords:
Lipoprotein(a)chronic total occlusionoutcomespercutaneous coronary intervention

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