Abstract

BackgroundHigh 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.MethodsA 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.ResultsPatients 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.ConclusionsHigh 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.

Highlights

  • It is estimated that the number of patients with diabetes mellitus (DM) has doubled in the past two decades [1]

  • Our study aimed to investigate whether high Lp(a) status was associated with an increased risk of procedural myocardial infarction (PMI), defined by the latest 2018 fourth universal definition of myocardial infarction (UDMI) [14], among a large-scale diabetic cohort undergoing Percutaneous Coronary Intervention (PCI)

  • Significant worse metabolic profiles exhibited in the high Lp(a) group, which were composed of high low-density lipoprotein (LDL) levels, and high Haemoglobin A1c (HbA1c) levels

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Summary

Introduction

It is estimated that the number of patients with diabetes mellitus (DM) has doubled in the past two decades [1]. It’s noteworthy to identify the risk factors that predict cardiac events in diabetic patients undergoing PCI. Peri-procedural myocardial infarction (PMI) is a procedurerelated ischemic cardiac event following coronary stenting [3]. Blood lipid profiles, including high-density lipoprotein (HDL), low-density lipoprotein (LDL), and fatty acid were demonstrated to have correlations with PCI-related myocardial injury [8,9,10]. 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

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