Lipoprotein(a), Oxidized Phospholipids, and Coronary Artery Disease Severity and Outcomes

被引：46

作者：

Gilliland, Thomas C. ^{[1
,2
,3
]}

Liu, Yuxi ^{[1
]}

Mohebi, Reza ^{[1
]}

Miksenas, Hannah ^{[1
]}

Haidermota, Sara ^{[1
,2
]}

Wong, Megan ^{[1
,2
]}

Hu, Xingdi ^{[4
]}

Cristino, Joaquim Rosado ^{[4
]}

Browne, Auris ^{[4
]}

Plutzky, Jorge ^{[3
,5
]}

Tsimikas, Sotirios ^{[6
]}

Januzzi Jr, James L. ^{[1
,3
,7
]}

Natarajan, Pradeep ^{[1
,2
,8
]}

机构：

[1] Massachusetts Gen Hosp, Div Cardiol, Boston, MA USA

[2] Broad Inst Harvard, Program Med & Pop ulat Genet & Cardiovasc Dis Init, Cambridge, MA USA

[3] Harvard Med Sch, Dept Med, Boston, MA USA

[4] Novartis Pharmaceut, E Hanover, NJ USA

[5] Brigham & Womens Hosp, Div Cardiol, Boston, MA USA

[6] Univ Calif San Diego, Sulpizio Cardiovasc Ctr, La Jolla, CA USA

[7] Baim Inst Clin Res, Boston, MA USA

[8] Massachusetts Gen Hosp, 185 Cambridge St,CPZN 3-184, Boston, MA 02114 USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2023年 / 81卷 / 18期

关键词：

atherosclerosis; coronary artery disease; lipids and lipoproteins; lipoprotein(a); CARDIOVASCULAR RISK-FACTORS; LOW-DENSITY-LIPOPROTEIN; ELEVATED LIPOPROTEIN(A); APOLIPOPROTEIN B-100; LP(A) LIPOPROTEIN; ASSOCIATION; THERAPY; ATHEROSCLEROSIS; ALIROCUMAB;

D O I：

10.1016/j.jacc.2023.02.050

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Lipoprotein(a) (Lp[a]) and oxidized phospholipids (OxPLs) are each independent risk factors for atherosclerotic cardiovascular disease. The extent to which Lp(a) and OxPLs predict coronary artery disease (CAD) severity and outcomes in a contemporary, statin-treated cohort is not well established. OBJECTIVES This study sought to evaluate the relationships between Lp(a) particle concentration and OxPLs associ-ated with apolipoprotein B (OxPL-apoB) or apolipoprotein(a) (OxPL-apo[a]) with angiographic CAD and cardiovascular outcomes.METHODS Among 1,098 participants referred for coronary angiography in the CASABLANCA (Catheter Sampled Blood Archive in Cardiovascular Diseases) study, Lp(a), OxPL-apoB, and OxPL-apo(a) were measured. Logistic regression esti-mated the risk of multivessel coronary stenoses by Lp(a)-related biomarker level. Cox proportional hazards regression estimated the risk of major adverse cardiovascular events (MACEs) (coronary revascularization, nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death) in follow-up.RESULTS Median Lp(a) was 26.45 nmol/L (IQR: 11.39-89.49 nmol/L). Lp(a), OxPL-apoB, and OxPL-apo(a) were highly correlated (Spearman R $0.91 for all pairwise combinations). Lp(a) and OxPL-apoB were associated with multivessel CAD. Odds of multivessel CAD per doubling of Lp(a), OxPL-apoB, and OxPL-apo(a) were 1.10 (95% CI: 1.03-1.18; P = 0.006), 1.18 (95% CI: 1.03-1.34; P = 0.01), and 1.07 (95% CI: 0.99-1.16; P = 0.07), respectively. All biomarkers were associated with cardiovascular events. HRs for MACE per doubling of Lp(a), OxPL-apoB, and OxPL-apo(a) were 1.08 (95% CI: 1.03-1.14; P = 0.001), 1.15 (95% CI: 1.05-1.26; P = 0.004), and 1.07 (95% CI: 1.01-1.14; P = 0.02), respectively.CONCLUSIONS In patients undergoing coronary angiography, Lp(a) and OxPL-apoB are associated with multivessel CAD. Lp(a), OxPL-apoB, and OxPL-apo(a) are associated with incident cardiovascular events. (Catheter Sampled Blood Archive in Cardiovascular Diseases [CASABLANCA]; NCT00842868) (J Am Coll Cardiol 2023;81:1780-1792) (c) 2023 by the American College of Cardiology Foundation.

引用

页码：1780 / 1792

页数：13

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