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Lipoprotein(a) and the Risk for Recurrent Atherosclerotic Cardiovascular Events Among Adults With CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study.

作者信息

Poudel Bharat, Rosenson Robert S, Kent Shia T, Bittner Vera, Gutiérrez Orlando M, Anderson Amanda H, Woodward Mark, Jackson Elizabeth A, Monda Keri L, Bajaj Archna, Huang Lei, Kansal Mayank, Rahman Mahboob, He Jiang, Muntner Paul, Colantonio Lisandro D

机构信息

Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama.

Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York.

出版信息

Kidney Med. 2023 May 5;5(7):100648. doi: 10.1016/j.xkme.2023.100648. eCollection 2023 Jul.


DOI:10.1016/j.xkme.2023.100648
PMID:37492110
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10363548/
Abstract

RATIONALE & OBJECTIVE: Many adults with chronic kidney disease (CKD) and atherosclerotic cardiovascular disease (ASCVD) have high lipoprotein(a) levels. It is unclear whether high lipoprotein(a) levels confer an increased risk for recurrent ASCVD events in this population. We estimated the risk for recurrent ASCVD events associated with lipoprotein(a) in adults with CKD and prevalent ASCVD. STUDY DESIGN: Observational cohort study. SETTING & PARTICIPANTS: We included 1,439 adults with CKD and prevalent ASCVD not on dialysis enrolled in the Chronic Renal Insufficiency Cohort study between 2003 and 2008. EXPOSURE: Baseline lipoprotein(a) mass concentration, measured using a latex-enhanced immunoturbidimetric assay. OUTCOMES: Recurrent ASCVD events (primary outcome), kidney failure, and death (exploratory outcomes) through 2019. ANALYTICAL APPROACH: We used Cox proportional-hazards regression models to estimate adjusted HR (aHRs) and 95% CIs. RESULTS: Among participants included in the current analysis (mean age 61.6 years, median lipoprotein(a) 29.4 mg/dL [25th-75th percentiles 9.9-70.9 mg/dL]), 641 had a recurrent ASCVD event, 510 developed kidney failure, and 845 died over a median follow-up of 6.6 years. The aHR for ASCVD events associated with 1 standard deviation (SD) higher log-transformed lipoprotein(a) was 1.04 (95% CI, 0.95-1.15). In subgroup analyses, 1 SD higher log-lipoprotein(a) was associated with an increased risk for ASCVD events in participants without diabetes (aHR, 1.23; 95% CI, 1.02-1.48), but there was no evidence of an association among those with diabetes (aHR, 0.99; 95% CI, 0.88-1.10, comparing aHRs = 0.031). The aHR associated with 1 SD higher log-lipoprotein(a) in the overall study population was 1.16 (95% CI, 1.04-1.28) for kidney failure and 1.02 (95% CI, 0.94-1.11) for death. LIMITATIONS: Lipoprotein(a) was not available in molar concentration. CONCLUSIONS: Lipoprotein(a) was not associated with the risk for recurrent ASCVD events in adults with CKD, although it was associated with a risk for kidney failure.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51eb/10363548/fe7dbc45244d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51eb/10363548/0ed0b0841222/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51eb/10363548/fe7dbc45244d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51eb/10363548/0ed0b0841222/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51eb/10363548/fe7dbc45244d/gr2.jpg

相似文献

[1]
Lipoprotein(a) and the Risk for Recurrent Atherosclerotic Cardiovascular Events Among Adults With CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study.

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[2]
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[3]
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[7]
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引用本文的文献

[1]
2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.

Circulation. 2025-2-25

[2]
Association of Lipoprotein(a) With Major Adverse Cardiovascular Events Across hs-CRP: A Systematic Review and Meta-Analysis.

JACC Adv. 2024-11-19

[3]
Association between lipoprotein (a) and risk of atherosclerotic cardiovascular disease events among maintenance hemodialysis patients in Beijing, China: a single-center, retrospective study.

BMC Nephrol. 2024-8-1

[4]
Genetics and Pathophysiological Mechanisms of Lipoprotein(a)-Associated Cardiovascular Risk.

J Am Heart Assoc. 2024-6-18

本文引用的文献

[1]
Strategies for lowering lipoprotein(a): a spotlight on novel pharmacological treatments.

Expert Rev Clin Pharmacol. 2023-2

[2]
Relationship of apolipoprotein(a) isoform size with clearance and production of lipoprotein(a) in a diverse cohort.

J Lipid Res. 2023-3

[3]
Serum lipoprotein (a) associates with the risk of renal function damage in the CHCN-BTH Study: Cross-sectional and Mendelian randomization analyses.

Front Endocrinol (Lausanne). 2022

[4]
Lipoprotein(a) levels and risk of adverse events after myocardial infarction in patients with and without diabetes.

J Thromb Thrombolysis. 2022-10

[5]
Lipoprotein(a) and the Risk for Coronary Heart Disease and Ischemic Stroke Events Among Black and White Adults With Cardiovascular Disease.

J Am Heart Assoc. 2022-6-7

[6]
Existing and emerging strategies to lower Lipoprotein(a).

Atherosclerosis. 2022-5

[7]
Atherosclerotic Cardiovascular Disease Events in Adults With CKD Taking a Moderate- or High-Intensity Statin: The Chronic Renal Insufficiency Cohort (CRIC) Study.

Kidney Med. 2021-6-19

[8]
New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race.

N Engl J Med. 2021-11-4

[9]
Pelacarsen for lowering lipoprotein(a): implications for patients with chronic kidney disease.

Clin Kidney J. 2020-2-11

[10]
Lipoprotein(a) Concentration and Risks of Cardiovascular Disease and Diabetes.

J Am Coll Cardiol. 2019-12-9

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