Key result
Elevated Lp(a) is linked to ~26% higher MACE risk in acute coronary syndrome patients.
Why the study?
Despite recognition of elevated lipoprotein (a) as an independent risk factor in ACS, consensus on its prognostic significance was limited.
Does an elevated lipoprotein (a) level increase the risk of major adverse cardiovascular events and all-cause mortality in patients with acute coronary syndrome?
Meta-Analysis (n=18,168)
Yes
Does an elevated lipoprotein (a) level increase the risk of major adverse cardiovascular events and all-cause mortality in patients with acute coronary syndrome?
Hazard Ratio: 1.26 (95% CI 1.17–1.35)
p-value: p=<0.00001
Elevated baseline lipoprotein (a) levels independently predict major adverse cardiovascular events and all-cause mortality in patients with acute coronary syndrome, supporting its potential utility for secondary risk stratification.
Supports Lp(a) measurement for ACS risk stratification; reinforces its independent prognostic value across studies.
Background Elevated lipoprotein (a) level was recognized as an independent risk factor for significant adverse cardiovascular events in acute coronary syndrome (ACS) patients. Despite this recognition, the consensus in the literature regarding the prognostic significance of elevated lipoprotein (a) in ACS was also limited. Consequently, we conducted a thorough systematic review and meta-analysis to evaluate the prognostic relevance of elevated lipoprotein (a) level in individuals diagnosed with ACS. Methods and results A thorough literature review was conducted by systematically searching PubMed, Embase, and Cochrane databases until September 2023. This review specifically examined cohort studies exploring the prognostic implications of elevated lipoprotein (a) level in relation to major adverse cardiovascular events (MACE), including death, stroke, non-fatal myocardial infarction (MI), and coronary revascularization, in patients with ACS. The meta-analysis utilized aggregated multivariable hazard ratios (HR) and their respective 95% confidence intervals (CI) to evaluate prognostic implications between high and low lipoprotein (a) levels [the cut-off of high lipoprotein (a) level varies from 12.5 to 60 mg/dl]. Among 18,168 patients in the identified studies, elevated lipoprotein (a) was independently associated with increased MACE risk (HR 1.26; 95% CI: 1.17–1.35, P < 0.00001) and all-cause mortality (HR 1.36; 95% CI: 1.05–1.76, P = 0.02) in ACS patients. In summary, elevated lipoprotein (a) levels independently forecast MACE and all-cause mortality in ACS patients. Assessing lipoprotein (a) levels appears promising for risk stratification in ACS, offering valuable insights for tailoring secondary prevention strategies. Systematic Review Registration PROSPERO (CRD42023476543).
No takes yet. Share an insight, caveat, or question.
Wang et al. (2024) conducted a meta-analysis in Acute Coronary Syndromes (n=18,168). Elevated lipoprotein (a) vs. Low lipoprotein (a) was evaluated on Major adverse cardiovascular events (MACE) (HR 1.26, 95% CI 1.17-1.35, p=<0.00001). Elevated lipoprotein (a) was independently associated with a 26% increased risk of MACE (HR 1.26, 95% CI 1.17-1.35, p<0.00001) in patients with acute coronary syndromes.
Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context: