Prognostic value of elevated lipoprotein(a) in patients with acute coronary syndromes

• DOI: 10.1111/eci.13117
• Publication Date: 2019-04-02T08:08:51Z
• Authors: Baris Gencer; Fabio Rigamonti; David Nanchen; Nicolas Vuilleumier; Ilse Kern; Soheila Aghlmandi; Roland Klingenberg; Lorenz Räber; Reto Auer; David Carballo; Sebastian Carballo; Dik Heg; Stephan Windecker; Thomas Felix Lüscher; Christian M. Matter; Nicolas Rodondi; François Mach
• Keywords: Mace; Lipoprotein(a)

Abstract Background Minimal lipoprotein(a) [Lp(a)] target values are advocated for high‐risk cardiovascular patients. We investigated the prognostic value of Lp(a) in acute setting patients with coronary syndromes (ACS). Materials and methods Plasma levels were collected at time angiography from 1711 hospitalized ACS a multicentre Swiss prospective cohort. Associations between elevated ≥30 mg/dL (cut‐off corresponding to 75th percentile assay) or tertiles baseline, major adverse events (MACE) 1 year, defined as composite cardiac death, myocardial infarction stroke, assessed using hazard ratios (HR) 95% confidence intervals (CI) adjusting traditional risk factors (age, sex, smoking, diabetes, hypertension, low‐density lipoprotein cholesterol [LDL‐C], high‐density [HDL‐C] triglycerides. Results range 2.5 132 median 6 mean 14.2 mg/dL. A total 276 (23.0%) had plasma Patients more likely be female gender have higher cholesterol, LDL‐C, HDL‐C Higher was associated failure reach LDL‐C <1.8 mmol/L year (HR 1.71, CI 1.13‐2.58, P = 0.01). No association found MACE 1.05, 0.64‐1.73), nor 0.82, 0.52‐1.28, > 0.20) standardized continuous variables (0.98, 0.82‐1.19 each increase standard deviation). Conclusions Our real‐world data suggest high not predictive outcomes otherwise medically well controlled, but might useful identify who would on targets after ACS.