Association of lipoprotein(a) with long-term mortality following coronary angiography or percutaneous coronary intervention

Clin Cardiol. 2017 Sep;40(9):674-678. doi: 10.1002/clc.22712. Epub 2017 Apr 26.

Abstract

Background: There is no consistent evidence to suggest the association of plasma lipoprotein(a) (Lp[a]) with long-term mortality in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI).

Hypothesis: Level of Lp(a) is associated with long-term mortality following CAG or PCI.

Methods: We enrolled 1684 patients with plasma Lp(a) data undergoing CAG or PCI between April 2009 and December 2013. The patients were divided into 2 groups: a low-Lp(a) group (Lp[a] <16.0 mg/dL; n = 842) and a high-Lp(a) group (Lp[a] ≥16.0 mg/dL; n = 842).

Results: In-hospital mortality was not significantly different between the high and low Lp(a) groups (0.8% vs 0.5%, respectively; P = 0.364). During the median follow-up period of 1.95 years, the high-Lp(a) group had a higher long-term mortality than did the low-Lp(a) group (5.8% vs 2.5%, respectively; P = 0.003). After adjustment of confounders, multivariate Cox regression analysis revealed that a higher Lp(a) level was an independent predictor of long-term mortality (hazard ratio: 1.96, 95% confidence interval: 1.07-3.59, P = 0.029).

Conclusions: Our data suggested that an elevated Lp(a) level was significantly associated with long-term mortality following CAG or PCI. However, additional larger multicenter studies will be required to investigate the predictive value of Lp(a) levels and evaluate the benefit of controlling Lp(a) levels for patients undergoing CAG or PCI.

Keywords: Coronary Angiography; Lipoprotein(a); Mortality; Percutaneous Coronary Intervention.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • Chi-Square Distribution
  • Coronary Angiography* / adverse effects
  • Coronary Angiography* / mortality
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / therapy
  • Female
  • Hospital Mortality
  • Humans
  • Kaplan-Meier Estimate
  • Lipoprotein(a) / blood*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Percutaneous Coronary Intervention* / adverse effects
  • Percutaneous Coronary Intervention* / mortality
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Up-Regulation

Substances

  • Biomarkers
  • Lipoprotein(a)