Feng Zhe, Li Hua-Long, Bei Wei-Jie, Guo Xiao-Sheng, Wang Kun, Yi Shi-Xin, Luo De-Mou, Li Xi-da, Chen Shi-Qun, Ran Peng, Chen Peng-Yuan, Islam Sheikh Mohammed Shariful, Chen Ji-Yan, Liu Yong, Zhou Ying-Ling
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Key Laboratory of Coronary Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
School of Medicine, South China University of Technology, Guangzhou, Guangdong, China.
Clin Cardiol. 2017 Sep;40(9):674-678. doi: 10.1002/clc.22712. Epub 2017 Apr 26.
There is no consistent evidence to suggest the association of plasma lipoprotein(a) (Lp[a]) with long-term mortality in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI).
Level of Lp(a) is associated with long-term mortality following CAG or PCI.
We enrolled 1684 patients with plasma Lp(a) data undergoing CAG or PCI between April 2009 and December 2013. The patients were divided into 2 groups: a low-Lp(a) group (Lp[a] <16.0 mg/dL; n = 842) and a high-Lp(a) group (Lp[a] ≥16.0 mg/dL; n = 842).
In-hospital mortality was not significantly different between the high and low Lp(a) groups (0.8% vs 0.5%, respectively; P = 0.364). During the median follow-up period of 1.95 years, the high-Lp(a) group had a higher long-term mortality than did the low-Lp(a) group (5.8% vs 2.5%, respectively; P = 0.003). After adjustment of confounders, multivariate Cox regression analysis revealed that a higher Lp(a) level was an independent predictor of long-term mortality (hazard ratio: 1.96, 95% confidence interval: 1.07-3.59, P = 0.029).
Our data suggested that an elevated Lp(a) level was significantly associated with long-term mortality following CAG or PCI. However, additional larger multicenter studies will be required to investigate the predictive value of Lp(a) levels and evaluate the benefit of controlling Lp(a) levels for patients undergoing CAG or PCI.
尚无一致证据表明血浆脂蛋白(a)[Lp(a)]与接受冠状动脉造影（CAG）或经皮冠状动脉介入治疗（PCI）患者的长期死亡率相关。
Lp(a)水平与CAG或PCI后的长期死亡率相关。
我们纳入了2009年4月至2013年12月期间接受CAG或PCI且有血浆Lp(a)数据的1684例患者。患者分为两组：低Lp(a)组[Lp(a)<16.0mg/dL；n = 842]和高Lp(a)组[Lp(a)≥16.0mg/dL；n = 842]。
高、低Lp(a)组的院内死亡率无显著差异（分别为0.8%和0.5%；P = 0.364）。在1.95年的中位随访期内，高Lp(a)组的长期死亡率高于低Lp(a)组（分别为5.8%和2.5%；P = 0.003）。在调整混杂因素后，多因素Cox回归分析显示，较高的Lp(a)水平是长期死亡率的独立预测因素（风险比：1.96，95%置信区间：1.07 - 3.59，P = 0.029）。
我们的数据表明，Lp(a)水平升高与CAG或PCI后的长期死亡率显著相关。然而，需要更多更大规模的多中心研究来调查Lp(a)水平的预测价值，并评估控制Lp(a)水平对接受CAG或PCI患者的益处。
