Postoperative LDL-C ≥2.6 mmol/L significantly increased the risk of major adverse cardiovascular events (aHR 3.90) compared to LDL-C <1.8 mmol/L in patients following coronary artery bypass grafting.
Observational (n=459)
Open-label
Yes
Does exposure to increased levels of postoperative LDL-C or baseline Lp(a) increase the risk of mid-term major adverse cardiovascular events in patients following coronary artery bypass grafting?
In patients undergoing coronary artery bypass grafting, elevated postoperative LDL-C (≥1.8 mmol/L) and baseline Lp(a) (≥30 mg/dL) are independently associated with an increased risk of mid-term major adverse cardiovascular events.
Effect estimate: aHR 3.90 (95% CI 2.29-6.64)
Absolute Event Rate: 45.8% vs 14%
p-value: p=<0.001
Purpose: The objective was to evaluate the influence of low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) Lp(a) on clinical outcomes in patients undergoing coronary artery bypass grafting (CABG). Methods: This is a secondary analysis of a 5-year follow-up of the DACAB trial (NCT02201771), in which 500 patients who underwent primary isolated CABG were randomized to three-antiplatelet therapy for 1 year after surgery. Of them, 459 patients were recruited in this secondary analysis. Baseline LDL-C and Lp(a) levels were collected, and repeated measurement of LDL-C levels during the follow-up were recorded. Cut-off values for LDL-C were set at 1.8 and 2.6 mmol/L; thus, the patients were stratified into LDL-C <1.8, 1.8-<2.6, and ≥2.6 mmol/L subgroups. Cut-off value for Lp(a) was 30 mg/dL; thus, the patients were divided into Lp(a) <30 and ≥30 mg/dL subgroups. The primary outcome was 4-point major adverse cardiovascular events (MACE-4), a composite of all-cause death, myocardial infarction, stroke, and repeated revascularization. Median follow-up time was 5.2 (interquartile range, 4.2-6.1) years. Results: = 0.022). Conclusions: For CABG patients, exposure to increased levels of postoperative LDL-C or baseline Lp(a) was associated with worse mid-term clinical outcomes. Our findings suggested the necessity of achieving LDL-C target and potential benefit of adding Lp(a) targeted lipid-lowering therapy in CABG population.
Yu et al. (Fri,) conducted a observational in Coronary artery disease following coronary artery bypass grafting (CABG) (n=459). Postoperative LDL-C ≥2.6 mmol/L vs. Postoperative LDL-C <1.8 mmol/L was evaluated on 4-point major adverse cardiovascular events (MACE-4) (aHR 3.90, 95% CI 2.29-6.64, p=<0.001). Postoperative LDL-C ≥2.6 mmol/L significantly increased the risk of major adverse cardiovascular events (aHR 3.90) compared to LDL-C <1.8 mmol/L in patients following coronary artery bypass grafting.