Abstract
Recent studies have suggested that lipoprotein(a) [Lp(a)] is associated with cardiovascular disease (CVD). However, the contribution of Lp(a) to residual risk of CVD has not been determined in Chinese populations. We conducted a prospective study to evaluate the association between Lp(a) and the risk of major adverse cardiovascular events (MACEs) in patients with stable coronary artery disease (CAD) who received optimal medication treatment (OMT). The study enrolled 1602 patients with stable CAD from 5 hospitals in China. The baseline clinical characteristics and follow-up MACE data for the patients were recorded. Coronary lesion severity was assessed by the Gensini scoring system. All-cause death, non-fatal myocardial infarction, non-fatal stroke and unplanned coronary revascularization were considered MACEs. We found that plasma Lp(a) levels were positively associated with coronary lesion severity at baseline (p < 0.001). During a mean follow-up period of 39.6 months, 166 (10.4%) patients suffered MACEs. There were significant differences in the adjusted event-free survival rates among the Lp(a) quartile subgroups (p = 0.034). The hazard ratio for MACEs was 1.291 (95% confidence interval: 1.091–1.527, p = 0.003) per standardized deviation in the log-transformed Lp(a) level after adjustment for traditional cardiovascular risk factors. Therefore, Lp(a) was an independent predictor of MACEs in Chinese patients with stable CAD who received OMT.
Highlights
Cardiovascular disease (CVD) has become a major cause of death worldwide
It is well appreciated that racial differences in LPA gene single nucleotide polymorphisms (SNPs), apo(a) sizes and Lp(a) levels exist[14] and that the cardiovascular disease (CVD) risk ascribed to Lp(a) relative to other risk factors may vary among different ethnicities[14]
The current study, to our best knowledge, is for the first time to investigate the association between Lp(a) and major adverse cardiovascular events (MACEs) in a Chinese cohort with existing stable coronary artery disease (CAD) who received optimal medical treatment (OMT)
Summary
Cardiovascular disease (CVD) has become a major cause of death worldwide. Low-density lipoprotein cholesterol (LDL-C) is known to play a crucial role in the pathogenesis of CVD, and decreases in plasma LDL-C levels result in significant reductions in CVD-related morbidity and mortality[1,2]. The majority of those are cross-sectional instead of prospective studies[19,20,21,22,23] They didn’t follow up patients and observed the incidence of cardiovascular events. Some of them only evaluated the association between Lp(a) and coronary stenosis severity or left ventricular ejection fraction at the baseline[19,23]. We conducted this prospective study to evaluate the association between plasma Lp(a) levels and the risk of major adverse cardiovascular events (MACEs) in a Chinese cohort with existing stable coronary artery disease (CAD) who received optimal medical treatment (OMT)
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