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Review
. 2024 May 25;16(5):e61069.
doi: 10.7759/cureus.61069. eCollection 2024 May.

Impact of Elevated Lipoprotein A on Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis

Tanya Sinha  1 , Manisha Guntha  2 , Abshiro H Mayow  3 , Aung K Zin  4 , Sandipkumar S Chaudhari  5   6 , Muhammad Waqas Khan  7 , Samer Kholoki  8 , Areeba Khan  9
Affiliations
Review

Impact of Elevated Lipoprotein A on Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis

Tanya Sinha et al. Cureus. .

Abstract

Lipoprotein(a) (Lp(a)) is an inherited lipoprotein particle associated with increased risk of atherosclerotic cardiovascular (CV) diseases. However, its impact on outcomes after percutaneous coronary intervention (PCI) remains unclear. The objective of this study was to assess the relationship between elevated Lp(a) levels and major adverse cardiovascular events (MACEs) and other outcomes in patients undergoing PCI. We systematically searched Embase, MEDLINE/PubMed, and Web of Science for studies published from 2015 to 2024 comparing CV outcomes between patients with elevated versus non-elevated Lp(a) levels after PCI. Primary outcome was MACE. Secondary outcomes included all-cause mortality, CV mortality, stroke, myocardial infarction, and revascularization. Risk ratios (RRs) were pooled using a random-effect model. Fifteen studies with 45,059 patients were included. Patients with elevated Lp(a) had a significantly higher risk of MACE (RR 1.38, 95% confidence interval (CI) 1.23-1.56). Elevated Lp(a) was also associated with increased risks of all-cause death (RR 1.26), CV death (RR 1.58), myocardial infarction (RR 1.44), revascularization (RR 1.38), and stroke (RR 1.18). Heterogeneity was considerable for some outcomes. This meta-analysis demonstrates that elevated Lp(a) levels are associated with worse CV outcomes, including higher rates of MACE, mortality, and recurrent ischemic events in patients undergoing PCI. Novel therapeutic approaches specifically targeting Lp(a) reduction may help mitigate residual CV risk in this high-risk population.

Keywords: cardiovascular outcomes; lipoprotein (a); mortality; percutaneous coronary intervention; systematic review and meta-analysis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA flowchart of study selection
PRISMA: Preferred Reporting Items for Systematic reviews and Meta-Analyses
Figure 2
Figure 2. Effect of elevated Lp(a) on MACE
References: [12,15,19,21-26]
See this image and copyright information in PMC

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