Abstract 13581: Effect of Lipoprotein(a) on Long-Term Outcomes at Different LDL-C and hs-CRP Status in Patients With Percutaneous Coronary Intervention
Jiawen Li, Kailun Yan, Yulong Li, Yuejin Yang, Jinqing Yuan, Xueyan Zhao- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Background: Although some studies have shown that the risk of adverse events associated with lipoprotein (a) [Lp(a)] are influenced by low-density lipoprotein cholesterol (LDL-C) or high-sensitivity C-reactive protein (hs-CRP) levels, results on whether hs-CRP and LDL-C jointly mediate the effect of Lp(a) on long-term outcomes are unknown.
Aim: To investigate the effect of Lp(a) on long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) according to LDL-C levels and further hs-CRP levels.
Methods: This prospective study consecutively enrolled 10,724 patients with PCI in the year 2013. The primary endpoint was all-cause death. The secondary endpoint was cardiac death.
Results: There were 10,000 patients with available baseline data included in final analysis (Age 58.33±10.26 years, 77.27% Male). During a median follow-up of 5.1 years, 358 patients developed all-cause death and 217 cardiac death. After the multi-variable Cox analysis, in the overall population, Lp(a) ≥ 30 mg/dL was an independent risk factor of all-cause death and cardiac death. Further analysis showed that, in patients with LDL-C < 70 mg/dL, Lp(a) ≥ 30 mg/dL was not an independent risk factor of all-cause death and cardiac death regardless of hs-CRP < 2 or ≥ 2 mg/L. However, when LDL-C ≥ 70 mg/dL, in the setting of hs-CRP ≥ 2 mg/L, Lp(a) ≥ 30 mg/dL was an independent risk factor of all-cause death and cardiac death; in the setting of hs-CRP < 2 mg/L, Lp(a) ≥ 30 mg/dL was only the independent risk factor of cardiac death.
Conclusions: The current study first reported that LDL-C and hs-CRP jointly affected the long-term outcomes associated with Lp(a) in PCI patients. When LDL-C < 70 mg/dL, Lp(a) ≥ 30 mg/dL was not associated with the risk of all-cause death and cardiac death irrespective of hs-CRP levels. Our finding may be instructive for the management and treatment of Lp(a) in the future.