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Prognostic significance of elevated lipoprotein(a) in coronary artery revascularization patients

 Sung Woo Kwon  ;  Byoung Kwon Lee  ;  Bum-Kee Hong  ;  Jong-Youn Kim  ;  Eui-Young Choi  ;  Ji Min Sung  ;  Ji-Hyuck Rhee  ;  Yoo Mi Park  ;  Dae Won Ma  ;  Hyemoon Chung  ;  Hee-Sun Mun  ;  Sung-Joo Lee  ;  Jong-Kwan Park  ;  Pil-Ki Min  ;  Young Won Yoon  ;  Se-Joong Rim  ;  Hyuck Moon Kwon 
 International Journal of Cardiology, Vol.167(5) : 1990-1994, 2013 
Journal Title
 International Journal of Cardiology 
Issue Date
BACKGROUND: Although lipoprotein(a) [Lp(a)] has been considered a cardiovascular risk factor for many years, there is a paucity of data in regard to the potential risk of elevated Lp(a) in symptomatic patients with CAD. Therefore, we sought to evaluate whether elevated Lp(a) is associated with worse outcome in symptomatic patients with coronary artery disease (CAD), and to clarify the prognostic value of Lp(a) in the era of coronary artery revascularization. METHODS: 6252 consecutive subjects (59.2% male, mean age 61.2 ± 11.2 years) suspected of having CAD underwent coronary angiography. Laboratory values for lipid parameters including Lp(a) were obtained on the day of coronary angiography. Baseline risk factors, coronary angiographic findings, length of follow-up, and major adverse cardiovascular events (MACE), including cardiac death and non-fatal myocardial infarction were recorded. RESULTS: Over a mean follow-up period of 3.1 ± 2.2 years, there were 100 MACE (56 cardiac deaths and 44 non-fatal myocardial infarctions), with an event rate of 1.6%. In multivariate Cox regression analysis, elevated Lp(a) was a significant predictor of MACE [hazard ratio 1.773 (95% confidence interval 1.194-2.634, p=0.005)], and the addition of this factor to the model significantly increased the global х(2) value over traditional risk factors and CAD (from 79.1 to 88.7, p=0.003). CONCLUSIONS: Elevated Lp(a) is an independent prognostic risk factor for cardiovascular events, and moreover, has incremental prognostic value in symptomatic patients with coronary artery revascularization.
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1. College of Medicine (의과대학) > Medical Research Center (임상의학연구센터) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
권성우(Kwon, Sung Woo)
권혁문(Kwon, Hyuck Moon) ORCID logo https://orcid.org/0000-0001-9901-5015
김종윤(Kim, Jong Youn) ORCID logo https://orcid.org/0000-0001-7040-8771
문희선(Mun, Hee Sun)
민필기(Min, Pil Ki) ORCID logo https://orcid.org/0000-0001-7033-7651
박유미(Park, Yoo Mi) ORCID logo https://orcid.org/0000-0002-3642-7300
성지민(Sung, Ji Min)
윤영원(Yoon, Young Won) ORCID logo https://orcid.org/0000-0002-0907-0350
이병권(Lee, Byoung Kwon) ORCID logo https://orcid.org/0000-0001-9259-2776
이지혁(Rhee, Ji Hyuk)
임세중(Rim, Se Joong) ORCID logo https://orcid.org/0000-0002-7631-5581
정혜문(Chung, Hye Moon)
최의영(Choi, Eui Young) ORCID logo https://orcid.org/0000-0003-3732-0190
홍범기(Hong, Bum Kee) ORCID logo https://orcid.org/0000-0002-6456-0184
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