Effect of an increase in Lp(a) following statin therapy on cardiovascular prognosis in secondary prevention population of coronary artery disease

BMC Cardiovascular Disorders

Research

Lijun Zhu¹  Yangliang Fang¹  Beibei Gao²  Jiamin Zheng²  Jinyu Huang²  Xiangbo Jin²  Ying He² 

[1] Department of Cardiology, Ningbo Municipal Medical Center LiHuili Hospital, Zhejiang, China;Department of Cardiology, The Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Zhejiang, China;

关键词: Lipoprotein(a);    Statin therapy;    Coronary artery disease;    Major adverse cardiovascular events;   

DOI  :  10.1186/s12872-022-02932-y

 received in 2022-08-30, accepted in 2022-10-31,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundLipoprotein (a) [Lp(a)] is an independent risk factor for coronary artery disease (CAD). Recent studies have indicated that statins tend to increase Lp(a) levels by 10–20%. However, the association of statin-mediated increases in Lp(a) levels with CAD has not been determined. MethodsThis study included 488 patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI). Lp(a) levels were measured at baseline and 1 month after statin therapy. The study endpoints were major adverse cardiovascular events (MACE). Hazard ratios for the MACE were adjusted for potential confounder using Cox regression.ResultsAfter statin therapy, the mean level of Lp(a) increased by 19.3% from baseline. Lp(a) levels increased in 307 patients (62.9%) with a median elevation of 4.1 mg/dL. Patients with an increase in Lp(a) were at higher risk for MACE than those without an increase in Lp(a) (p = 0.044). Subgroup analyses revealed that a mild-to-moderate increase in Lp(a) was not associated with MACE, whereas there was a strong correlation between the highest quartile increase in Lp(a) (≥ 10.1 mg/dL) and MACE (HR = 2.29, 95%CI = 1.36–3.84, p = 0.002). This correlation was independent of baseline Lp(a) levels but not independent of on-statin Lp(a) levels.ConclusionsSevere increases in Lp(a) following statin therapy raise the risk of MACE, but a mild-to-moderate increase in Lp(a) may not affect the cardiovascular prognosis of CAD patients. Even if the baseline Lp(a) levels are low, it is necessary to continue testing for Lp(a) concentration at least once after statin.

【 授权许可】

CC BY   
© The Author(s) 2022. corrected publication 2022

【 图 表 】

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