Key result
Higher Lp(a) linked to ~44% greater MACE risk over two years in premature ACS.
Why the study?
Little is known about the association between lipoprotein(a) levels and future ischemic cardiovascular events in patients with premature acute coronary syndrome.
Do higher serum Lipoprotein(a) levels predict major adverse cardiovascular events in patients with premature acute coronary syndrome?
Cohort (n=1,464)
Do higher serum Lipoprotein(a) levels predict major adverse cardiovascular events in patients with premature acute coronary syndrome?
Hazard Ratio: 1.443 (95% CI 1.074–1.937)
p-value: p=.015
Elevated Lipoprotein(a) levels independently predict major adverse cardiovascular events in patients with premature acute coronary syndrome, highlighting its value for risk stratification.
Supports Lp(a)-based risk stratification in premature ACS; leaves open whether targeted lowering improves outcomes.
Little is known about the association between lipoprotein(a) [Lp(a)] levels and future ischemic cardiovascular events in patients with premature acute coronary syndrome (ACS). A total of 1464 consecutive patients who underwent coronary angiography for premature ACS (males <45 years and females <55 years) were enrolled in this study. Patients were divided into quartiles according to serum Lp(a) levels (Q1: ≤11.1 nmol/L; Q2: 11.1-27.7 nmol/L; Q3: 27.7-79.3 nmol/L; and Q4: >79.3 nmol/L). Major adverse cardiovascular events (MACEs) increased with Lp(a) quartiles after 2-year follow-up (among quartiles, respectively; P = .001). Kaplan-Meier curves revealed significant differences in event-free survival rates among Lp(a) quartile groups ( P = .001). Multivariate Cox proportional hazards regression analysis indicated that serum Lp(a) level was an independent predictor of MACE either as a continuous variable (hazard ratio [HR]: 1.002, 95% confidence interval [CI]: 1.001-1.004; P = .009) or as a categorical variable (HR: 1.443, 95% CI: 1.074-1.937; P = .015). Furthermore, Lp(a) levels (as a variable) significantly improved the prognostic value for MACE. These findings suggest that Lp(a) measurement has value for cardiovascular risk stratification in patients with premature ACS.
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Wang et al. (2019) conducted a cohort in Premature acute coronary syndrome (ACS) (n=1,464). Serum lipoprotein(a) levels vs. Lower lipoprotein(a) levels was evaluated on Major adverse cardiovascular events (MACEs) (HR 1.443, 95% CI 1.074-1.937, p=.015). Serum lipoprotein(a) levels independently predicted major adverse cardiovascular events over 2 years in patients with premature ACS (HR 1.443; 95% CI 1.074-1.937; P=0.015 as a categorical variable).
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