Impact of Lipoprotein (a) on Long-Term Outcomes in Patients With Acute Myocardial Infarction

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  • Dai Kazuoki
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Shiode Nobuo
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Yoshii Kanade
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Kimura Yuka
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Matsuo Keita
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Jyuri Yusuke
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Tomomori Shunsuke
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Higaki Tadanao
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Oi Kuniomi
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Kawase Tomoharu
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Sairaku Akinori
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Ohashi Norihiko
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Suenari Kazuyoshi
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Nishioka Kenji
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Masaoka Yoshiko
    Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
  • Nakano Yukiko
    Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences

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Abstract

<p>Background: Lipoprotein (a) (Lp(a)) is a complex circulating lipoprotein, and there is increasing evidence it is a risk factor for atherosclerotic cardiovascular disease (ASCVD). This study aimed to investigate the influence of Lp(a) serum levels on long-term outcomes after acute myocardial infarction (AMI).</p><p>Methods and Results: Between January 2015 and January 2018, we enrolled 262 patients with AMI who underwent coronary angiography within 24 h of the onset of chest pain and had available Lp(a) data enabling subdivision into 2 groups: high Lp(a) (≥32 mg/dL: n=76) and low Lp(a) (<32 mg/dL: n=186). The primary endpoint was major adverse cardiac events (MACE), which was defined as a composite of cardiac death, nonfatal MI, and readmission for heart failure. Multivariate Cox regression analysis was performed to identify the predictors of MACE. The incidence of MACE was significantly higher in the high Lp(a) group than in the low Lp(a) group (32.8% vs. 19.6%, P=0.004). Multivariate analysis showed that Lp(a) ≥32 mg/dL was an independent predictor of MACE (hazard ratio 2.84, 95% confidence interval 1.25–6.60, P=0.013).</p><p>Conclusions: High Lp(a) levels were associated with worse long-term outcomes after AMI, so Lp(a) may be useful for risk assessment.</p>

Journal

  • Circulation Journal

    Circulation Journal 87 (10), 1356-1361, 2023-09-25

    The Japanese Circulation Society

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