The nonlinear association between lipoprotein(a) and major adverse cardiovascular events in acute coronary syndrome patients with three-vessel disease

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: Jan. 11, 2025

Lipoprotein(a) [Lp(a)] is a lipoprotein with potent atherogenic and thrombogenic potential. Its role in patients acute coronary syndrome (ACS) combined three-vessel disease (TVD) remains unclear. This study aimed to investigate the correlation between Lp(a) levels occurrence of major adverse cardiovascular events (MACE) ACS TVD. Patients who underwent angiography were diagnosed TVD selected for study. divided into three groups based on their levels. The MACE was evaluated using univariate multivariate Cox regression analysis, subgroup sensitivity Kaplan-Meier survival curve, receiver operating characteristic curve (ROC), restricted cubic spline plot (RCS). A total 1504 included, median follow-up time 38 months. Univariate analysis showed that higher had significantly increased incidence (P < 0.001). After adjusting confounding factors, indicated high remained an independent predictor 0.05). Subgroup revealed associated risk subgroups including aged ≥ 60 years, males, those hypertension, CKD, without diabetes, hyperlipidemia, stroke Sensitivity further confirmed close cumulative group than low-level ROC some predictive value (AUC: 0.623, 95% CI: 0.593-0.653, P RCS demonstrated after transforming normal distribution as Log10Lp(a), there approximately U-shaped nonlinear association Log10Lp(a)

Language: Английский

Effect of Increased Level of Lipoprotein(a) on Cardiovascular Outcomes in Patients With Ischemic Heart Disease: A Systematic Review and Meta-Analysis

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 31, 2024

Lipoprotein(a) (Lp(a)) has emerged as a significant cardiovascular risk factor, particularly in patients with ischemic heart disease (IHD). This systematic review and meta-analysis aimed to synthesize evidence on the impact of Lp(a) levels outcomes IHD patients. A comprehensive literature search was conducted across multiple databases, covering publications from January 2016 October 2024. Studies assessing relationship between were included. The primary major adverse events (MACE), all-cause mortality, myocardial infarction, revascularization. Quality assessment performed using Newcastle-Ottawa Scale. Fourteen studies (five prospective, nine retrospective) met inclusion criteria, sample sizes ranging 350 18,544 participants. Pooled analysis revealed that elevated significantly associated increased MACE (HR: 1.31, 95% CI: 1.19-1.45), mortality 1.23, 1.15-1.31), infarction 1.20, 1.06-1.35), revascularization 1.08-1.39) Sensitivity analyses confirmed robustness these findings. provides strong are findings underscore potential role an important prognostic marker suggest incorporating into clinical practice could enhance stratification. Future research should focus establishing optimal cutoff values evaluating Lp(a)-lowering therapies this high-risk population.

Language: Английский