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. 2021 Feb 3:11:603922.
doi: 10.3389/fendo.2020.603922. eCollection 2020.

Association Between Lipoprotein(a) and Peri-procedural Myocardial Infarction in Patients With Diabetes Mellitus Who Underwent Percutaneous Coronary Intervention

Yupeng Liu  1   2   3 , Wenyao Wang  1 , Jingjing Song  1   2   3 , Kuo Zhang  1 , Bo Xu  4 , Ping Li  1 , Chunli Shao  1 , Min Yang  1 , Jing Chen  1 , Yi-Da Tang  1   2   3
Affiliations

Association Between Lipoprotein(a) and Peri-procedural Myocardial Infarction in Patients With Diabetes Mellitus Who Underwent Percutaneous Coronary Intervention

Yupeng Liu et al. Front Endocrinol (Lausanne). .

Abstract

Background: High lipoprotein(a) (Lp[a]) levels are associated with increased risks of cardiovascular events in Percutaneous Coronary Intervention (PCI) patients with diabetes mellitus (DM). Peri-procedural myocardial infarction (PMI) occurs commonly during the PCI, whereas the relationship between Lp(a) and PMI remains unclear. Our study aimed to evaluate the association between Lp(a) value and the incidence of PMI in a larger-scale diabetic cohort undergoing PCI throughout 2013.

Methods: A total of 2,190 consecutive patients with DM were divided into two groups according to the median Lp(a) level of 175 mg/L: Low Lp(a) group (N = 1095) and high Lp(a) group (N = 1095). PMI was defined based on the 2018 universal definition of myocardial infarction.

Results: Patients with high Lp(a) levels exhibited higher rates of PMI compared to those with low Lp(a) levels (2.3% versus 0.8%, P = 0.006). The multivariable logistic analysis showed that PMI was independently predicted by Lp(a) as a dichotomous variable (OR 2.64, 95%CI 1.22-5.70) and as a continuous variable (OR 1.57, 95% CI 1.12-2.20). However, further investigation found that this association was only maintained in men, whose Lp(a) levels were significantly associated with the frequency of PMI, both as a dichotomous variable (OR 3.66, 95%CI 1.34-10.01) and as a continuous variable (OR 1.81, 95%CI 1.18-2.78). Lp(a) wasn't a risk factor of PMI in women.

Conclusions: High Lp(a) levels had forceful correlations with the increased frequency of PMI in male diabetic patients undergoing PCI. Lp(a) might act as a marker of risk stratification and a therapeutic target to reduce PCI-related ischemic events.

Keywords: coronary artery disease; diabetes mellitus; lipoprotein(a); percutaneous coronary intervention; peri-procedural myocardial infarction.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Incidence of peri-procedural myocardial infarction. Lp(a), lipoprotein(a); high Lp(a), Lp(a) > 175 mg/L.
Figure 2
Figure 2
Receiver-operating characteristics analysis. AUC, the area under the receiver-operating curve.
Figure 3
Figure 3
Kaplan-Meier survival curves for composite endpoints of all-cause mortality and myocardial infarction (A) and 2-year rates of the indicated events (B) according to the presence or absence of PMI. PMI, peri-procedural myocardial infarction; MI, myocardial infarction.
See this image and copyright information in PMC

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