Lipoprotein(a) plasma levels are not associated with survival after acute coronary syndromes: An observational cohort study


Autoři: Christian Roth aff001;  Konstantin A. Krychtiuk aff001;  Clemens Gangl aff001;  Lore Schrutka aff001;  Klaus Distelmaier aff001;  Johann Wojta aff001;  Christian Hengstenberg aff001;  Rudolf Berger aff003;  Walter S. Speidl aff001
Působiště autorů: Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria aff001;  Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria aff002;  Department of Internal Medicine I, Cardiology and Nephrology, Hospital of St. John of God, Eisenstadt, Austria aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1371/journal.pone.0227054

Souhrn

Background

Lipoprotein(a) [Lp(a)] is associated with coronary artery disease in population studies, however studies on its predictive value in patients with cardiovascular disease, in particular after acute coronary syndromes (ACS), are conflicting. The aim of this study was to investigate whether Lp(a) is associated with survival after ACS.

Methods and results

We analyzed Lp(a) measurement in 1,245 patients who underwent coronary angiography for ACS. The median follow-up for cardiovascular and all-cause mortality was 5.0 (IQR 3.2–8.0) years. 655 (52.6%) presented with ST-segment elevation myocardial infarction (STEMI), 424 (34.1%) with Non-ST-segment elevation myocardial infarction (NSTEMI) and 166 (13.3%) underwent coronary angiography for unstable angina. Cardiovascular mortality was 9.1% and all-cause mortality was 15.7%. Patients were stratified into four groups to their Lp(a) levels. (≤15mg/dL, >15-30mg/dL, >30-60mg/dL, and >60mg/dL). Multivessel disease was significantly more common in patients with Lp(a)>60mg/dL (p<0.05). Increased levels of Lp(a) were not associated with cardiovascular mortality (HR compared with Lp(a) ≤15mg/dL were 1.2, 1.2, and 1.0, respectively; p = 0.69) and not with all-cause mortality (HR compared with Lp(a) ≤15mg/dL were 1.2, 1.2, and 1.2, respectively; p = 0.46).

Conclusions

Lp(a) levels at time of ACS were neither associated with cardiovascular nor with all-cause mortality. Although Lp(a) has been shown to be associated with incidence of coronary artery disease, this study does not support any role of Lp(a) as a risk factor for mortality after ACS. This should be taken into account for development of outcome studies for agents targeting Lp(a) plasma levels.

Klíčová slova:

Angiography – Blood plasma – Coronary heart disease – Diabetes mellitus – Hypertension – Cholesterol – Lipoproteins – Medical risk factors


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2020 Číslo 1

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