Key result
High lipoprotein(a) levels (≥50 mg/dL) were associated with a significantly increased risk of MACE at 5 years compared to low levels (26.5% vs. 19.5%; HR 1.50; 95% CI 1.29-1.73; P<0.001).
Why the study?
Does elevated Lp(a) (≥50 mg/dL) increase the risk of MACE in patients undergoing successful PCI with DES?
Cohort (n=2,020)
Does elevated Lp(a) (≥50 mg/dL) increase the risk of MACE in patients undergoing successful PCI with DES?
Elevated Lp(a) levels (≥50 mg/dL) are independently associated with a 50% increased risk of MACE at 5 years following successful PCI with DES.
Background While high lipoprotein(a) (Lp[a]) concentrations have been implicated in the development of atherosclerotic cardiovascular disease, their role in determining post-percutaneous coronary intervention (PCI) clinical outcomes, particularly in the era of drug-eluting stent (DES), remains unclear. Purpose This study aimed to evaluate the prognostic significance of elevated Lp(a) levels in patients undergoing PCI with DES and its association with long-term adverse cardiovascular outcomes. Methods A total of 2,020 patients who underwent successful PCI with DES were retrospectively analyzed. Based on an Lp(a) threshold of 50 mg/dL, patients were classified into high and low Lp(a) groups. The primary outcome was major adverse cardiovascular events (MACE), a composite endpoint including all-cause mortality, myocardial infarction, repeat revascularization, and stent thrombosis, assessed at 5-year follow-up. Results Among the total cohort, 16% (n = 319) had high Lp(a) levels. After inverse probability of treatment weighting (IPTW) analysis, the high Lp(a) group showed a significantly greater incidence of MACE compared to the low Lp(a) group (26.5% vs. 19.5%; HR: 1.50; 95% CI: 1.29-1.73; P < 0.001). Specifically, the risks of myocardial infarction (6.3% vs. 3.6%; HR: 1.79; 95% CI: 1.34-2.41; P < 0.001), repeat revascularization (19.4% vs. 13.6%; HR: 1.52; 95% CI: 1.29-1.80; P < 0.001), and stent thrombosis (3.3% vs. 1.8%; HR: 1.83; 95% CI: 1.23-2.74; P = 0.003) were significantly elevated in the high Lp(a) group. These associations remained consistent across various statistical models and subgroup analyses. Conclusion Elevated Lp(a) levels were independently associated with increased long-term cardiovascular risk following PCI with DES, particularly in terms of recurrent ischemic events and stent-related complications. These findings highlight the importance of considering Lp(a) as a prognostic marker in post-PCI risk stratification and suggest that targeted Lp(a)-lowering strategies may play a role in secondary prevention for high-risk patients.
No takes yet. Share an insight, caveat, or question.
Her et al. (2025) conducted a cohort in Post-percutaneous coronary intervention (PCI) with drug-eluting stents (DES) (n=2,020). High lipoprotein(a) (≥50 mg/dL) vs. Low lipoprotein(a) (<50 mg/dL) was evaluated on Major adverse cardiovascular events (MACE), a composite of all-cause mortality, myocardial infarction, repeat revascularization, and stent thrombosis (HR 1.50, 95% CI 1.29-1.73, p=<0.001). High lipoprotein(a) levels (≥50 mg/dL) were associated with a significantly increased risk of MACE at 5 years compared to low levels (26.5% vs. 19.5%; HR 1.50; 95% CI 1.29-1.73; P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: