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Clinical Trial
. 2017 Nov 1;24(11):1125-1131.
doi: 10.5551/jat.38794. Epub 2017 Mar 17.

Impact of Lipoprotein (a) on Long-Term Outcomes in Patients with Coronary Artery Disease Treated with Statin After a First Percutaneous Coronary Intervention

Satoru Suwa  1 , Manabu Ogita  1 , Katsumi Miyauchi  2 , Taketo Sonoda  1 , Hirokazu Konishi  1 , Shuta Tsuboi  1 , Hideki Wada  2 , Ryo Naito  2 , Tomotaka Dohi  2 , Takatoshi Kasai  2 , Shinya Okazaki  2 , Kikuo Isoda  1 , Hiroyuki Daida  2
Affiliations
Clinical Trial

Impact of Lipoprotein (a) on Long-Term Outcomes in Patients with Coronary Artery Disease Treated with Statin After a First Percutaneous Coronary Intervention

Satoru Suwa et al. J Atheroscler Thromb. .

Abstract

Aims: Cardiovascular risk persists despite intensive lipid lowering therapy using statins. Serum levels of lipoprotein (a) [Lp(a)] can be a residual cardiovascular risk for adverse events. Aim of the present study was to evaluate the impact of Lp(a) on long-term clinical outcomes in patients treated with statin after percutaneous coronary intervention.

Methods: We prospectively enrolled 3507 consecutive CAD patients who underwent a first percutaneous coronary intervention (PCI) between 1997 and 2011 at our institution. We identified 1768 patients (50.4%) who had treated with statin during PCI. Eligible 1336 patients were stratified to two groups according to Lp(a) levels (median Lp (a) 21.5 mg/dL). The primary outcome was major adverse cardiac events (MACE) including cardiac death and non-fatal acute coronary syndrome.

Results: MACE occurred 144 (10.8%) including 34 (2.5%) cardiac death and 110 (8.7%) non-fatal ACS during median follow-up period of 1920 days. The cumulative rate of MACE was significantly higher in group with high Lp(a) group (log-rank p=0.0460). Multivariate Cox regression analysis showed a significant correlation between Lp (a) levels treated as a natural logarithm-transformed continuous variable and increased MACE (adjusted HR for MACE 1.28, 95%CI 1.04-1.58, p=0.0184)Conclusion: Elevated levels of Lp(a) is significantly associated with long-term adverse clinical outcomes among CAD patients who received statin therapy after PCI.

Keywords: Coronary artery disease; Lipoprotein (a); Percutaneous coronary intervention; Statin.

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Figures

Fig. 1.
Fig. 1.
Study flow chart
Fig. 2.
Fig. 2.
The distribution of Lp(a) levels
Fig. 3.
Fig. 3.
Kaplan-Meier curves for MACE
See this image and copyright information in PMC

References

    1. Scandinavian Simvastatin Survival Study Group: Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet, 1994; 344: 1383-1389 - PubMed
    1. Cannon CP, Braunwald E, McCabe CH, Rada DJ, Rouleau JL, Belder R, Joyal SV, Hill KA, Pfeffer MA, Skene AM, for the Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarctioni 22 Investigators : Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Eng J Med, 2004; 350: 1495-1504 - PubMed
    1. Mora S, Wenger NK, DeMicco DA, Breazna A, Boekholdt SM, Arsenault BJ, Deedwania P, Kastelein JJ, Waters DD: Determinants of residual risk in secondary prevention patients treated with high- versus low-dose statin therapy: the Treating to New Targets (TNT) study. Circulation, 2012; 125: 1979-1987 - PMC - PubMed
    1. Reith C, Armitage J: Management of residual risk after statin therapy. Atherosclerosis, 2016; 245: 161-170 - PubMed
    1. Tsimikas S, Hall JL: Lipoprotein (a) as a potential casual genetic risk factor of cardiovascular disease: a rationale for increased efforts to understand its pathophysiology and develop targeted therapies. J Am Coll Cardiol, 2012; 60: 716-721 - PubMed

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