Key result
Elevated Lp(a) linked to ~38% higher MACE risk in patients undergoing PCI.
Why the study?
The impact of elevated lipoprotein(a) on clinical outcomes after percutaneous coronary intervention remains unclear.
Does elevated Lipoprotein(a) increase the risk of MACE and other adverse cardiovascular outcomes in patients undergoing percutaneous coronary intervention?
Meta-Analysis (n=45,059)
Does elevated Lipoprotein(a) increase the risk of MACE and other adverse cardiovascular outcomes in patients undergoing percutaneous coronary intervention?
Relative Risk: 1.38 (95% CI 1.23–1.56)
p-value: p=<0.01
Elevated Lipoprotein(a) is significantly associated with increased risks of MACE, mortality, and recurrent ischemic events in patients undergoing PCI, highlighting it as a marker of residual cardiovascular risk.
Elevated Lp(a) signals higher post-PCI MACE risk; extends observational evidence but leaves open whether targeted lowering improves outcomes.
Lipoprotein(a) (Lp(a)) is an inherited lipoprotein particle associated with increased risk of atherosclerotic cardiovascular (CV) diseases. However, its impact on outcomes after percutaneous coronary intervention (PCI) remains unclear. The objective of this study was to assess the relationship between elevated Lp(a) levels and major adverse cardiovascular events (MACEs) and other outcomes in patients undergoing PCI. We systematically searched Embase, MEDLINE/PubMed, and Web of Science for studies published from 2015 to 2024 comparing CV outcomes between patients with elevated versus non-elevated Lp(a) levels after PCI. Primary outcome was MACE. Secondary outcomes included all-cause mortality, CV mortality, stroke, myocardial infarction, and revascularization. Risk ratios (RRs) were pooled using a random-effect model. Fifteen studies with 45,059 patients were included. Patients with elevated Lp(a) had a significantly higher risk of MACE (RR 1.38, 95% confidence interval (CI) 1.23-1.56). Elevated Lp(a) was also associated with increased risks of all-cause death (RR 1.26), CV death (RR 1.58), myocardial infarction (RR 1.44), revascularization (RR 1.38), and stroke (RR 1.18). Heterogeneity was considerable for some outcomes. This meta-analysis demonstrates that elevated Lp(a) levels are associated with worse CV outcomes, including higher rates of MACE, mortality, and recurrent ischemic events in patients undergoing PCI. Novel therapeutic approaches specifically targeting Lp(a) reduction may help mitigate residual CV risk in this high-risk population.
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Sinha et al. (2024) conducted a meta-analysis in Percutaneous coronary intervention (PCI) (n=45,059). Elevated Lipoprotein(a) vs. Non-elevated Lipoprotein(a) was evaluated on Major adverse cardiovascular events (MACE) (RR 1.38, 95% CI 1.23-1.56, p=<0.01). Elevated Lipoprotein(a) levels were significantly associated with a 38% higher risk of major adverse cardiovascular events (RR 1.38) in patients undergoing percutaneous coronary intervention.
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