Lp(a) level is associated with long-term adverse outcomes in patients with coronary heart disease

FENG Zhe; LIU Yong; CHEN Ji-yan; ZHOU Ying-ling

摘要：Background Mounting evidence has suggested that high level of Lipoprotein (a) (Lp [a]) is associated with increased risk of coronary heart disease (CHD).However,the impact of Lp (a) on long-term adverse outcomes of CHD undergone coronary angiography (CAG) or percutaneous coronary intervention (PCI) has not been fully examined.Methods We enrolled 1684 patients with CHD between October 2009 and December 2013.The patients were divided into two group according to their median plasma Lp (a) levels:Lp (a)＜16.03 mg/dL (n=842 patients),and Lp (a) ≥ 16.03 mg/dL (n=842 patients).Kaplan-Meier curve was carried out examining the survival time between the two groups.The associations of Lp(a) levels and long-term major adverse cardiovascular events (MACEs) were investigated by cox regression analysis.Results Patients with the high Lp(a) did not have an increased risk of in-hospital MACEs (3.0％ vs.1.7％,P=0.075),but had a higher long-term MACEs than those in the low Lp (a) group (6.3％ vs.3.1％,P=0.005).With the median follow-up period of 1.94 years,multivariate Cox regression analysis revealed that a higher Lp (a) level was an independent predictor of longterm MACEs (hazard ratio 1.82,95％ confidence interval 1.04 to 3.18,P=0.036).Conclusion An elevated level of Lp (a) is significantly associated with long-term adverse outcomes in patients with CHD following CAG or PCI.