Hyperlipoproteinemia(a) and its impact on prognosis in patients with acute coronary syndrome

Bliznyuk S.A.; Komarova A.G.; Ezhov M.V.; Chashchin M.G.

doi:https://doi.org/10.17116/Cardiobulletin20252002137

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BACKGROUND

Lipoprotein(a) [Lp(a)] is an independent risk factor of ischemic heart disease, peripheral atherosclerosis, ischemic stroke, and aortic valve calcification. The relationship between elevated Lp(a) and recurrent cardiovascular events (CVE) among patients who have experienced acute coronary syndrome (ACS) remains a matter of debate.

OBJECTIVE

To investigate the role of Lp(a) in recurrent CVE within one year after discharge in patients with ACS.

MATERIAL AND METHODS

The study included patients with ST-segment elevation acute myocardial infarction, non-ST-segment elevation myocardial infarction and unstable angina. Incidence of composite endpoint and individual events was analyzed.

RESULTS

We followed-up 446 patients over a 12-month period including 267 men (59.9%) and 179 women (40.1%). The median age was 67 years [58; 75]. The composite endpoint (recurrent ACS, repeat percutaneous coronary interventions, cardiovascular mortality) was recorded in 20.9% (n=93) of patients. The risk ratio for non-fatal CVE, adjusted for sex, age, final diagnosis, initial Killip class, troponin I, diabetes mellitus, left ventricular ejection fraction, three-vessel coronary artery disease and aortic valve stenosis was found to be 1.005 (95% CI: 1.001—1.008) for serum Lp(a). Thus, Lp(a) increase by each 1 mg/dL is associated with significantly higher risk of non-fatal CVE by 0.5%.

CONCLUSION

Analysis of serum Lp(a) is important in patients with ACS. This lipoprotein may be considered a potential risk stratification factor for recurrent cardiovascular events within one year following ACS.

Keywords:

lipoprotein(a)

acute coronary syndrome

recurrent cardiovascular events

Authors:

Bliznyuk S.A.

Botkin Moscow Multifield Scientific Clinical Center

ORCID: 0000-0002-2619-1592

Komarova A.G.

Botkin Moscow Multifield Scientific Clinical Center

ORCID: 0000-0002-8633-7012

Ezhov M.V.

Chazov National Medical Research Center of Cardiology

ORCID: 0000-0002-1518-6552

Chashchin M.G.

National Medical Research Center for Therapy and Preventive Medicine

SPIN RSCI: 4511-5960
Scopus AuthorID: 57273613700
ORCID: 0000-0001-6292-3837

Received:

24.01.2025

Accepted:

27.03.2025

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References:

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