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

Authors
 Sung Woo Kwon ; Byoung Kwon Lee ; Hyuck Moon Kwon ; Se-Joong Rim ; Young Won Yoon ; Pil-Ki Min ; Jong-Kwan Park ; Sung-Joo Lee ; Hee-Sun Mun ; Hyemoon Chung ; Dae Won Ma ; Yoo Mi Park ; Ji-Hyuck Rhee ; Ji Min Sung ; Eui-Young Choi ; Jong-Youn Kim ; Bum-Kee Hong 
Citation
 International Journal of Cardiology, Vol.167(5) : 1990~1994, 2013 
Journal Title
 International Journal of Cardiology 
ISSN
 0167-5273 
Issue Date
2013
Abstract
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.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/87618
DOI
10.1016/j.ijcard.2012.05.007
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Medical Research Center
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S0167527312006183
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