High plasma lipoprotein lipase is associated with a lower risk for future major adverse cardiovascular events in patients following carotid endarterectomy

Abstract

Background and Aims : Since carotid plaque intraplaque hemorrhage is associated with plaque progression leading to cardiovascular events, we hypothesized that blood proteins associated with carotid plaque IPH are also likely to be associated with MACE after CEA.Methods: In 688 patients undergoing CEA of the Athero-Express biobank, we measured 276 proteins using three OLINK® proteomics immunoassays in preoperative blood samples. We analyzed the association of proteins with IPH using logistic regression analyses. In addition, we analyzed the association of candidate proteins with the three-year postoperative risk of MACE (including stroke, myocardial infarction, and cardiovascular death).Results: A total of 130 patients (18,9%) developed MACE during the three-year follow-up. We found six proteins to be significantly associated with IPH, from which Lipoprotein Lipase was associated with the postoperative risk of MACE undergoing CEA. We analyzed the association of LPL with MACE within two different time periods, since the proportional hazard assumption for LPL was violated. High LPL was associated with an increased risk for 30-day MACE (adjusted HR per SD:1.60(1.10-2.30), p=0.014), while high LPL was associated with a lower risk for MACE within 30-days up and till 3-year (adjusted HR per SD:0.80(0.65-0.99), p=0.036).Conclusions: Of the six proteins that were associated with IPH, only LPL was associated with the risk for MACE. High LPL was independently associated with an increased risk of MACE within the first 30-days after CEA, while high LPL was associated with a lower risk of MACE in the period 30 days up and till 3-years. Background and Aims : Since carotid plaque intraplaque hemorrhage is associated with plaque progression leading to cardiovascular events, we hypothesized that blood proteins associated with carotid plaque IPH are also likely to be associated with MACE after CEA. Methods: In 688 patients undergoing CEA of the Athero-Express biobank, we measured 276 proteins using three OLINK® proteomics immunoassays in preoperative blood samples. We analyzed the association of proteins with IPH using logistic regression analyses. In addition, we analyzed the association of candidate proteins with the three-year postoperative risk of MACE (including stroke, myocardial infarction, and cardiovascular death). Results: A total of 130 patients (18,9%) developed MACE during the three-year follow-up. We found six proteins to be significantly associated with IPH, from which Lipoprotein Lipase was associated with the postoperative risk of MACE undergoing CEA. We analyzed the association of LPL with MACE within two different time periods, since the proportional hazard assumption for LPL was violated. High LPL was associated with an increased risk for 30-day MACE (adjusted HR per SD:1.60(1.10-2.30), p=0.014), while high LPL was associated with a lower risk for MACE within 30-days up and till 3-year (adjusted HR per SD:0.80(0.65-0.99), p=0.036). Conclusions: Of the six proteins that were associated with IPH, only LPL was associated with the risk for MACE. High LPL was independently associated with an increased risk of MACE within the first 30-days after CEA, while high LPL was associated with a lower risk of MACE in the period 30 days up and till 3-years.