- 作者：Sung Woo Kwon ; Byoung Kwon Lee ; Bum-Kee Hong ; Jong-Youn Kim ; Eui-Young Choi ; Ji Min Sung ; Ji-Hyuck Rhee ; Yoo Mi Park ; Dae Won Ma ; Hyemoon Chung ; Hee-Sun Mun ; Sung-Joo Lee ; Jong-Kwan Park ; Pil-Ki Min ; Young Won Yoon ; Se-Joong Rim ; Hyuck Moon Kwon
- 关键词：CABG ; coronary artery bypass graft surgery ; CAD ; coronary artery disease ; CI ; confidence interval ; CRT ; coronary revascularization treatment ; HDL ; high-density lipoprotein ; HR ; hazard ratio ; LDL ; low-density lipoprotein ; Lp(a) ; lipoprotein(a) ; MACE ; major
- 刊名：International Journal of Cardiology
- 出版年：2013
- 出版时间：1 September, 2013
- 年：2013
- 卷：167
- 期：5
- 页码：1990-1994
- 全文大小：369 K
Background
Although lipoprotein(a) [Lp(a)] has been considered a cardiovascular risk factor for many years, there is a paucity of data in regard to the potential risk of elevated Lp(a) in symptomatic patients with CAD. Therefore, we sought to evaluate whether elevated Lp(a) is associated with worse outcome in symptomatic patients with coronary artery disease (CAD), and to clarify the prognostic value of Lp(a) in the era of coronary artery revascularization.Methods
6252 consecutive subjects (59.2 % male, mean age 61.2 ¡À 11.2 years) suspected of having CAD underwent coronary angiography. Laboratory values for lipid parameters including Lp(a) were obtained on the day of coronary angiography. Baseline risk factors, coronary angiographic findings, length of follow-up, and major adverse cardiovascular events (MACE), including cardiac death and non-fatal myocardial infarction were recorded.
Results
Over a mean follow-up period of 3.1 ¡À 2.2 years, there were 100 MACE (56 cardiac deaths and 44 non-fatal myocardial infarctions), with an event rate of 1.6 % . In multivariate Cox regression analysis, elevated Lp(a) was a significant predictor of MACE [hazard ratio 1.773 (95 % confidence interval 1.194-2.634, p = 0.005)], and the addition of this factor to the model significantly increased the global §ç2 value over traditional risk factors and CAD (from 79.1 to 88.7, p = 0.003).
Conclusions
Elevated Lp(a) is an independent prognostic risk factor for cardiovascular events, and moreover, has incremental prognostic value in symptomatic patients with coronary artery revascularization.