Prognostic impact of lipoprotein (a) on long-term clinical outcomes in diabetic patients on statin treatment after percutaneous coronary intervention

被引：10

作者：

Takahashi, Norihito ^{[1
]}

Dohi, Tomotaka ^{[1
]}

Funamizu, Takehiro ^{[1
]}

Endo, Hirohisa ^{[1
]}

Wada, Hideki ^{[2
]}

Doi, Shinichiro ^{[1
]}

Kato, Yoshiteru ^{[1
]}

Ogita, Manabu ^{[2
]}

Okai, Iwao ^{[1
]}

Iwata, Hiroshi ^{[1
]}

Okazaki, Shinya ^{[1
]}

Isoda, Kikuo ^{[1
]}

Miyauchi, Katsumi ^{[1
]}

Shimada, Kazunori ^{[1
]}

机构：

[1] Juntendo Univ, Dept Cardiovasc Med, Grad Sch Med, Tokyo, Japan

[2] Juntendo Univ, Dept Cardiol, Shizuoka Hosp, Shizuoka, Japan

来源：

JOURNAL OF CARDIOLOGY | 2020年 / 76卷 / 01期

关键词：

Lipoprotein (a); Residual risk; Biomarker; Coronary artery disease; Percutaneous coronary intervention; Diabetes mellitus; CARDIOVASCULAR RISK; HEART-DISEASE; OXIDIZED PHOSPHOLIPIDS; VASCULAR-DISEASE; RESIDUAL RISK; APOLIPOPROTEIN; MELLITUS; EVENTS; ATHEROSCLEROSIS; EPIDEMIOLOGY;

D O I：

10.1016/j.jjcc.2020.01.013

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Serum levels of lipoprotein (a) [Lp(a)] have been reported as a residual risk marker for adverse events in patients with coronary artery disease (CAD). However, the prognostic impact of Lp(a) on long-term clinical outcomes among diabetic patients on statin therapy after percutaneous coronary intervention (PCI) remains unclear. Methods: The present investigation was a single-center, observational, retrospective cohort study. Among consecutive patients with CAD who underwent first PCI in our institution from 2000 to 2016, we enrolled diabetic patients on statin treatment. As a result, 927 patients (81% men; mean age, 67 years) were enrolled and divided into 2 groups according to a median Lp(a) level of 19.5 mg/dL. The incidence of major adverse cardiac events (MACE), including all-cause death, non-fatal myocardial infarction (MI), and non-fatal cerebral infarction (CI), was evaluated. Result: No significant differences were seen in age, sex, smoking habits, hypertension, chronic kidney disease, or body mass index between high and low Lp(a) groups. During follow-up (median, 5.0 years; interquartile range, 1.9-9.7 years), MACE occurred in 90 cases (17.6%), including 40 (7.9%) cardiac deaths, 18 (3.6%) non-fatal MI, and 37 (7.9%) non-fatal CI. Frequency of MACE was significantly higher in the highLp(a) group than in the low-Lp(a) group (log-rank test, p = 0.002). Higher Lp(a) level at the time of PCI was significantly associated with higher frequency of MACE, even after adjusting for other covariates, including other lipid profiles (hazard ratio, 1.91; 95% confidence interval, 1.20-3.09; p = 0.006). Conclusion: Our results demonstrated that in diabetic patients with CAD on statin treatment, increased Lp(a) levels could offer a good residual lipid risk marker. Assessing Lp(a) levels may be useful for risk stratification of long-term clinical outcomes after PCI, especially in diabetic patients. (C) 2020 Japanese College of Cardiology. Published by Elsevier Ltd. All rights

引用

页码：25 / 29

页数：5

共 46 条

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