Author + information
- Sung Woo Kwon,
- Byoung Kwon Lee,
- Jong-Youn Kim,
- Eui-Young Choi,
- Pil-Ki Min,
- Young Won Yoon,
- Bum-Kee Hong,
- Se-Joong Rim and
- Hyuck Moon Kwon
We sought to evaluate whether elevated lipoprotein(a) [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.
6252 consecutive subjects (59.2% male, mean age 61.2 ± 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, and analyses were done shortly after sampling. 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.
Over a mean follow-up period of 3.1 ± 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) (= 20 mg/dl) 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 chi-square value over traditional risk factors and CAD (from 79.1 to 88.7, p = 0.003).
Elevated Lp(a) is an independent prognostic risk factor for cardiovascular events, and moreover, has incremental prognostic value in symptomatic patients with coronary artery disease, irrespective of coronary artery revascularization status.
ACC Moderated Poster Contributions
McCormick Place South, Hall A
Monday, March 26, 2012, 9:30 a.m.-10:30 a.m.
Session Title: New Twists with Older Risk Markers in SIHD
Abstract Category: 2. Chronic CAD/Stable Ischemic Heart Disease: Clinical
Presentation Number: 1199-129
- 2012 American College of Cardiology Foundation