Abstract
Recent studies and guidelines have indicated that lipoprotein(a) [Lp(a)]was an independent risk factor of arteriosclerotic cardiovascular disease (ASCVD). This study aimed to determine the relationship between serum Lp(a) levels and the risk of periprocedural myocardial injury following percutaneous coronary intervention (PCI) in coronary heartdisease (CHD) patients. This study enrolled 528 nonacute myocardial infarction (AMI) coronary heart disease (CHD) patients who successfully underwent PCI. Fasting serum lipids including Lp(a) were tested before PCI. High‐sensitivity cardiac troponin I (hs‐cTnI) was tested before PCI and 24 h after PCI. Univariate and multivariate logistic regression analyses were used to determine the relationship between preprocedural Lp(a) levels and postprocedural cTnI elevation from 1 × upper limit of normal (ULN) to 70 × ULN. As a continuous variable, multivariate analyses adjusting for conventional covariates and other serum lipids revealed that increased Lp(a) levels were independently associated with the risk of elevated postprocedural cTnI values above 1 × ULN (odds ratio [OR] per log‐unit higher: 1.31, 95% confidence interval [CI]: 1.02–1.68, P = 0.033], 5 × ULN (OR: 1.25, 95%CI: 1.02–1.53, P = 0.032), 10 × ULN (OR: 1.48, 95%CI: 1.18–1.86, P = 0.001) and 15 × ULN (OR: 1.28, 95%CI: 1.01–1.61, P = 0.038). As a categorical variable, Lp(a) > 300 mg/L was an independent risk factor of postproceduralc TnI≥1 × ULN (OR 2.17, 95%CI 1.12–4.21, P = 0.022), ≥5 × ULN (OR 1.82, 95%CI 1.12–2.97, P = 0.017) and ≥10 × ULN (OR 2.17, 95%CI 1.33–3.54, P = 0.002). Therefore, it could be concluded that elevated preprocedural Lp(a) levels were associated with the risk of PCI‐related myocardial injury in non‐AMI CHD patients.
Highlights
Lipoprotein(a) [Lp(a)] is a lipoprotein composed of low-density lipoprotein (LDL) and an additional protein apolipoprotein(a).[1]
It is a member of human plasma lipoproteins which include chylomicrons, very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), LDL and high-density lipoprotein (HDL).[2]
Our study demonstrated the positive correlation of preprocedural Lp(a) levels and postprocedural cTnI levels in non-acute myocardial infarction (AMI) coronary heart disease (CHD) patients undergoing elective Percutaneous coronary intervention (PCI), indicating that Lp(a) was an independent risk factor of PCI-related myocardial injury
Summary
Lipoprotein(a) [Lp(a)] is a lipoprotein composed of low-density lipoprotein (LDL) and an additional protein apolipoprotein(a).[1] It is a member of human plasma lipoproteins which include chylomicrons, very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), LDL and high-density lipoprotein (HDL).[2] LDL consisting of cholesterol and apoB-100 delivers cholesterol from liver to peripheral tissues.[3] For decades, low-density lipoprotein cholesterol (LDL-C) has already been proven to be the most important risk factor atherosclerosis cardiovascular disease (ASCVD).[2,4,5,6,7] Different to LDL, an additional apolipoprotein(a) [apo(a)] makes the physiological and vascular effects of Lp(a) ambiguous.[1] uncertain mechanism as it was, studies have already reported the positive correlation between plasma Lp(a) levels and the risk of ASCVD.[8,9] Recent ESC/EAS guidelines for the management of dyslipidaemias recommended at least once measurement of Lp(a) in the lifetime to identify the persons who may have a lifetime risk of ASCVD.[2]
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