ShaMa Azhi, Ma Chunlan, Huang Yingying, Hu Jingyue, Xu Chunmei, Li Zhuxin, Wang Jing, Zeng Chunyu
Department of Cardiology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing, People's Republic of China.
Department of Neurology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing, People's Republic of China.
Tex Heart Inst J. 2024 Dec 17;51(2):e238372. doi: 10.14503/THIJ-23-8372. eCollection 2024 Jul-Dec.
Elevated lipoprotein(a) (Lp[a]) is a risk factor for first atherosclerotic thrombosis events, but the role of elevated Lp(a) in secondary prevention is controversial. This study aimed to retrospectively investigate the influence of elevated Lp(a) levels on the prognosis of patients with coronary artery disease.
The team collected and compared clinical information of patients hospitalized during percutaneous coronary intervention (PCI). This study used a multivariate logistic regression model to evaluate the relationships between Lp(a) levels, cardiovascular risk factors, and the prognosis of coronary artery disease in patients undergoing PCI.
There were no statistically significant differences between patients grouped according to Lp(a) level in terms of sex; age; body mass index and obesity; hyperuricemia; smoking; cardiac insufficiency; acute myocardial infarction; multivessel lesion; in-stent restenosis; secondary PCI; apolipoprotein AI level; incidence of high total cholesterol or high low-density lipoprotein cholesterol; or family history of hypertension, diabetes, or coronary artery disease. The average Lp(a) concentration did not statistically significantly decrease after 1 year of statin treatment after PCI. One year after patients began statins, there were no significant differences between Lp(a) groups in the incidence of high triglycerides ( = .13), high total cholesterol ( = .52), or high low-density lipoprotein cholesterol ( = .051). Multivariate logistic regression analysis indicated that diabetes ( = .02) was associated with in-stent restenosis, whereas diabetes ( = .02) and multivessel lesions ( < .001) were associated with secondary PCI in patients who underwent coronary angiography 1 year after PCI. Compared with normal Lp(a) levels, high Lp(a) levels did not significantly increase the incidence of in-stent restenosis or secondary PCI in patients who underwent coronary angiography 1 year after PCI.
Sustained high concentrations of Lp(a) did not significantly increase the incidence of in-stent restenosis or secondary PCI in patients who underwent coronary angiography 1 year after PCI.
脂蛋白(a)[Lp(a)]升高是首次动脉粥样硬化血栓形成事件的危险因素，但Lp(a)升高在二级预防中的作用存在争议。本研究旨在回顾性调查Lp(a)水平升高对冠心病患者预后的影响。
研究团队收集并比较了接受经皮冠状动脉介入治疗（PCI）期间住院患者的临床信息。本研究使用多因素逻辑回归模型评估Lp(a)水平、心血管危险因素与接受PCI患者冠心病预后之间的关系。
根据Lp(a)水平分组的患者在性别、年龄、体重指数和肥胖、高尿酸血症、吸烟、心脏功能不全、急性心肌梗死、多支血管病变、支架内再狭窄、二次PCI、载脂蛋白AI水平、高总胆固醇或高低密度脂蛋白胆固醇发生率或高血压、糖尿病或冠心病家族史方面无统计学显著差异。PCI术后他汀类药物治疗1年后，平均Lp(a)浓度无统计学显著下降。患者开始使用他汀类药物1年后，Lp(a)组在高甘油三酯发生率（P = 0.13）、高总胆固醇发生率（P = 0.52）或高低密度脂蛋白胆固醇发生率（P = 0.051）方面无显著差异。多因素逻辑回归分析表明，糖尿病（P = 0.02）与支架内再狭窄相关，而糖尿病（P = 0.02）和多支血管病变（P < 0.001）与PCI术后1年接受冠状动脉造影的患者二次PCI相关。与正常Lp(a)水平相比，高Lp(a)水平并未显著增加PCI术后1年接受冠状动脉造影患者的支架内再狭窄或二次PCI发生率。
持续高浓度的Lp(a)并未显著增加PCI术后1年接受冠状动脉造影患者的支架内再狭窄或二次PCI发生率。
