Association of lipoprotein (a) and in-hospital outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention

Wu, Baoquan; Zhao, Hanjun; Liu, Changhua; Lu, Hao; Liu, Ruishuang; Long, Juan; Zhang, Zhiling; Zeng, Fanfang

doi:10.1080/00325481.2020.1845517

Cited by 8 publications

(17 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Percutaneous coronary intervention (PCI) is currently the preferred strategy for the treatment of myocardial infarction, as it provides early and effective culprit artery opening, thus restoring myocardial reperfusion and saving the endangered damaged myocytes. However, other factors, such as smoking habit, male sex, and the inner diameter of the right coronary artery, may affect the prognosis of patients with acute myocardial infarction and high thrombotic load[ 3 , 4 ], and the best timing of PCI remains elusive in these patients[ 5 , 6 ]. The aim of this study was to analyze the effect of emergency PCI and direct stenting in comparison with delayed stenting in the treatment of patient with acute myocardial infarction and high thrombotic load, and to assess the related factors of adverse cardiovascular events after treatment in order to provide clinical guidance and basis.…”

Section: Introductionmentioning

confidence: 99%

Postoperative adverse cardiac events in acute myocardial infarction with high thrombus load and best time for stent implantation

Zhuo¹,

Zhang²,

Shen³

et al. 2022

WJCC

View full text Add to dashboard Cite

BACKGROUND Myocardial infarction is one of the most common types of coronary heart disease. It is mainly caused by the rupture of coronary atherosclerotic plaque, which leads to platelet agglutination and thrombosis. The occlusion of coronary arteries and vessels leads to insufficient myocardial blood supply, subsequently causing cardiac interstitial fibrosis, gradual enlargement of ventricles, and heart failure, which affects the quality of life and safety of patients. AIM To investigate the effects of emergency percutaneous interventional therapy (PCI) and delayed stenting in acute myocardial infarction with high thrombotic load and identify factors related to major adverse cardiovascular events (MACE). METHODS A total of 164 patients with acute myocardial infarction and high thrombotic load who received PCI were included. Of them, 92 patients were treated with delayed stent implantation (delayed group) and 72 patients received emergency PCI (immediate group). Myocardial perfusion after stent implantation was compared between the two groups. Patients were followed up for 12 mo, and the occurrence of MACE was used as the endpoint. Univariate and multivariate models were used to analyze the factors affecting MACE occurrence. RESULTS After stent implantation, 66 (71.74%) patients in the delayed group and 40 (55.56%) patients in the immediate group had thrombolysis in myocardial infarction (TIMI) flow grade 3 ( P < 0.05), while 61 (66.30%) patients in the delayed group and 39 (54.17%) patients in the immediate group reached TIMI myocardial perfusion grade 3 ( P > 0.05). MACE occurred in 29 patients. There were statistically significant differences between the MACE and non-MACE groups in diabetes rate, TIMI grading, stent implantation timing, intraoperative use of tirofiban, and the levels of white blood cells (WBC), neutrophils, red blood cell distribution width (RDW), and uric acid, and high-sensitivity C-reactive protein (hs-CRP) at admission ( P < 0.05). Logistic regression analysis showed that TIMI grade 3 and intraoperative use of tirofiban effectively reduced the risk of MACE ( P < 0.05), while immediate stent implantation, increased WBC, hs-CRP and RDW on admission increased the risk of MACE ( P < 0.05). CONCLUSION Delayed stent implantation outweighs emergency PCI in improving postoperative myocardial perfusion in acute myocardial infarction with high thrombotic load, and effectively reduces MACE in these patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Postoperative adverse cardiac events in acute myocardial infarction with high thrombus load and best time for stent implantation

Zhuo¹,

Zhang²,

Shen³

et al. 2022

WJCC

View full text Add to dashboard Cite

show abstract

“…Interestingly and importantly, in recent decade, few studies from the western populations suggested that elevated serum lipoprotein (a) [Lp(a)] level was associated with HF development 8,9 . Some studies reported that elevated serum Lp(a) level at baseline was associated with worse prognosis in HF patients 10–12 . Nevertheless, the mechanisms are not fully understood yet, which deserves further elucidation.…”

Section: Introductionmentioning

confidence: 99%

“…These pathophysiological processes together lead to cardiovascular events 13–16 . One recent study suggested that in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), elevated Lp(a) level was associated with a higher risk of in‐hospital cardiovascular event, including incident HF 10 . However, whether this association would be modified by baseline systemic inflammation was unknown.…”

Section: Introductionmentioning

confidence: 99%

Association of lipoprotein (a) and 1 year prognosis in patients with heart failure with reduced ejection fraction

Liu

Shen

et al. 2022

ESC Heart Failure

View full text Add to dashboard Cite

AimCurrent study was to evaluate relationship between baseline serum lipoprotein (a) [Lp(a)] level and prognosis in patients with heart failure with reduced ejection fraction (HFrEF) and to explore whether the relationship would be modified by baseline high-sensitivity C-reactive protein (Hs-CRP) level. Methods and resultsThis is an observational prospective study. HFrEF patients from outpatient clinic were consecutively recruited (n = 362). Based on Lp(a) cutoff (30 mg/dL), patients were divided into normal and high Lp(a) groups; and based on Hs-CRP cutoff (3 mg/dL), patients were divided into low-degree and high-degree groups. The 1 year rate of HF rehospitalization was similar between these two groups (22.7% vs. 24.1%, P = 0.18), while the 1 year rate of cardiovascular mortality was higher in Lp(a) ≥ 30 mg/dL versus Lp(a) < 30 mg/dL groups (20.3% vs. 13.3%, P = 0.009), as was composite endpoint (44.4% vs. 36.0%, P < 0.001). After adjusting for covariates, elevated Lp(a) level remained associated with a higher risk of cardiovascular mortality [hazard ratio (HR) 1.22 and 95% confidence interval (CI) 1.04-1.64, P = 0.02] and composite endpoint (HR 1.38 and 95% CI 1.16-2.01, P = 0.006). In Hs-CRP ≥ 3 mg/dL group, elevated Lp(a) level was associated with HF rehospitalization, cardiovascular mortality, and composite endpoint, which was not observed in Hs-CRP < 3 mg/dL group. The association was greater for cardiovascular mortality (P-interaction = 0.04) and composite endpoint (P-interaction = 0.02) in Hs-CRP ≥ 3 mg/ dL versus Hs-CRP < 3 mg/dL groups. Conclusion Elevated Lp(a) level is associated with higher risk of cardiovascular mortality in HFrEF patients, which might be due to enhanced systemic inflammation.

show abstract

“…Several studies have demonstrated that Lp(a) is an independent risk factor for atherosclerotic cardiovascular disease due to its pro‐atherosclerotic and pro‐thrombotic effects 9–12 . In addition, high serum Lp(a) level was related to an increased risk of acute ischemic events, incident HF, and cardiovascular mortality 9–14 . For example, our prior study has indicated that among individuals with acute coronary syndrome undergoing percutaneous coronary intervention, compared to those with low serum Lp(a) level, individuals with high serum Lp(a) level had a higher risk of developing congestive HF during hospitalization 13 .…”

Section: Introductionmentioning

confidence: 99%

“… 9 , 10 , 11 , 12 In addition, high serum Lp(a) level was related to an increased risk of acute ischemic events, incident HF, and cardiovascular mortality. 9 , 10 , 11 , 12 , 13 , 14 For example, our prior study has indicated that among individuals with acute coronary syndrome undergoing percutaneous coronary intervention, compared to those with low serum Lp(a) level, individuals with high serum Lp(a) level had a higher risk of developing congestive HF during hospitalization. 13 Interestingly, results from the Multi‐Ethnic Study of Atherosclerosis (MESA) cohort study suggested that increased serum Lp(a) level at baseline was associated with incident HF only in the White but not in the Black, Hispanic, or Chinese populations.…”

Section: Introductionmentioning

confidence: 99%

Association between lipoprotein (a) and heart failure with reduced ejection fraction development

Zhang

Long

et al. 2021

Clinical Laboratory Analysis

Self Cite

View full text Add to dashboard Cite

Background The current study aimed to evaluate the relationship between baseline serum lipoprotein (a) [Lp(a)] level and heart failure with reduced ejection fraction (HFrEF) development. Methods This was a retrospective study, and participants were enrolled from the outpatient clinic. All data were extracted from the electronic health record of the outpatient clinic system. The follow‐up was performed through reviewing the clinical notes at the outpatient clinic system, and study outcome of the current study was the first diagnosis of HFrEF. Participants were divided into low Lp(a) (<30 mg/dl, n = 336) and high Lp(a) (≥30 mg/dl, n = 584) groups. Results Individuals in the high Lp(a) group were more likely to be men and have diabetes mellitus (DM) and dyslipidemia. Increased Lp(a) at baseline was positively associated with serum N‐terminal pro‐B natriuretic peptide level while negatively associated with left ventricular ejection fraction (LVEF) at follow‐up. After adjusting for covariates, per 10 mg/dl increase in baseline Lp(a) remained significantly associated with HFrEF, with odds ratio of 1.17 (95% confidence interval of 1.05, 1.46). The magnitude of association between baseline Lp(a) level and HFrEF was greater in men and in individuals with DM or coronary heart disease (CHD), while it was weaker in individuals treated with beta‐blocker at baseline. Conclusion Increased Lp(a) at baseline was associated with HFrEF development. The adverse effects of Lp(a) were greater on men and individuals with DM or CHD, which were mitigated by beta‐blocker therapy. These findings together underscore the possibility and usefulness of Lp(a) as a new risk factor to predict HFrEF.

show abstract

Association of lipoprotein (a) and in-hospital outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention

Cited by 8 publications

References 32 publications

Postoperative adverse cardiac events in acute myocardial infarction with high thrombus load and best time for stent implantation

Postoperative adverse cardiac events in acute myocardial infarction with high thrombus load and best time for stent implantation

Association of lipoprotein (a) and 1 year prognosis in patients with heart failure with reduced ejection fraction

Association between lipoprotein (a) and heart failure with reduced ejection fraction development

Contact Info

Product

Resources

About