Impact of lipoprotein(a) as a residual risk on long-term cardiovascular outcomes in patients with acute coronary syndrome treated with statin

Abstract

Abstract Background It is still uncertain that lipoprotein(a) [Lp(a)] concentration could be a residual risk for cardiovascular events among patients with acute coronary syndrome (ACS). Purpose The aim of the present study is to evaluate the impact of Lp(a) on long-term cardiovascular outcomes in patients with ACS treated with statins. Methods We studied 1758 consecutive ACS patients who underwent emergency percutaneous coronary intervention (PCI). We finally enrolled 1131 patients who had data of Lp(a) and were treated with statin. They were divided into two groups according to Lp(a) levels (15.0mg/dL). Primary endpoint was major adverse cardiac events (MACE), composite of all-cause death and myocardial infarction. Results The cumulative incidence of MACE was significantly higher in the high Lp(a) group than in the low Lp(a) group. After adjustment for other risk factors, the high Lp(a) group had a significantly higher risk of MACE compared with the low Lp(a) group (HR 1.59, 95% CI 1.01–2.48, p=0.04). Multivariate Cox hazard analysis also showed that increasing Lp(a) was associated with worse clinical outcomes (HR 1.33 per log Lp(a) 1 increase, 95% CI 1.05–1.69, p=0.02). Conclusions Elevated levels of Lp(a) is significantly associated with long-term cardiovascular outcomes among ACS patients treated with statin. Funding Acknowledgement Type of funding sources: None.